Table 2 Salient beliefs associated with helping patients clarify their values and preferences regarding evidence-based dietary treatment options
From: Exploring dietitians' salient beliefs about shared decision-making behaviors
Salient beliefs | Quotes illustrating the belief | Frequency of mentiona |
|---|---|---|
Behavioral beliefs--perceived advantages | ||
Targets the treatment | "If their [patients'] values include having fun, going to restaurants, sharing meals, this is important so we consider these values in our options." | 4 |
Improves the patient's adherence to the treatment | "Adherence to treatment, again." | 4 |
Increases the patient's trust in the dietitian | "Maybe it establishes a sense of respect between the health professional and the patient if the patient sees that the dietitian respects his values." | 4 |
Increases the patient's awareness | "Making him [the patient] conscious about his values. For some it's unconscious, they do it but they don't realize it." | 2 |
Increases the patient's satisfaction | "His [the patient's] satisfaction. Feeling a bit more involved, like we don't decide for him, he gets the feeling that he's not just a number in this big healthcare system, he's directly involved. So there is probably some kind of appreciation for this approach." | 2 |
Saves time | "It is the opposite of presenting all the options, which requires more time, but when you know your patient's values and preferences, maybe you can save time and not spend an hour with the patient ..." | 2 |
Behavioral beliefs--perceived disadvantages | ||
Confronts the patient | "There are some [patients] who don't like being confronted." | 2 |
Normative beliefs--approval | ||
Patient's family | "The family." | 3 |
Multidisciplinary team | "Multidisciplinary teams, with nurses, physicians..." | 4 |
Physician | "Physicians." | 2 |
Normative beliefs--disapproval | ||
Patient's family | "... so if you try to deconstruct some values that were transmitted by the family... In my opinion, it's the only people [family] who I see who might find it inconvenient." | 2 |
Multidisciplinary team | "It all depends on who is involved, what team." | 2 |
Control beliefs--barriers | ||
Lack of time | "We don't have time to question the patient. It's possible that we don't delve into his values." | 4 |
Lack of patient openness | "He [the patient] may not be interested in opening up to each health professional..." | 4 |
Patient's medical condition | "The fact also that sometimes, in some departments, for example if I think about surgery, when we see surgery patients, it's not when they're at their best." | 4 |
Patient's age | "...when it's been many years that you [the patient] have adopted a behavior, it's always more difficult to question and discuss it [the behavior]." | 2 |
Patient has little trust in the dietitian | "...if we are not able to establish trust right from the beginning, we can't go very far." | 2 |
Patient does not express him/herself clearly | "...or a patient that is not able to express himself very clearly." | 2 |
Control beliefs--facilitators | ||
Patient trusts the dietitian | "To establish trust [with the patient]." | 2 |
Dietitian has enough time | "Again, to be able to follow up with the patient." | 3 |
Patient's family support | "When the entire family is willing to change their behavior, the children, the spouse make the changes too and everyone is motivated." | 2 |
Motivated patient | "If the decision comes from the patient, that's another facilitator." | 2 |
Good listening ability on the part of the dietitian | "If you [the dietitian] understand why he [the patient] has difficulty managing his body weight: because he has an overloaded work schedule, if you listen to him..., then you facilitate the process." | 2 |
Good openness on the part of the patient | "Patient openness." | 2 |