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Decisional needs assessment of patients with complex care needs in primary care : a participatory systematic mixed studies review protocol

Bujold Mathieu, Pluye Pierre, Légaré France, Haggerty Jeannie, Gore Geneviève C., El Sherif Reem, Poitras Marie-Ève, Beaulieu Marie-Claude, Beaulieu Marie-Dominique, Bush Paula Li, Couturier Yves, Débarges Béatrice, Gagnon Justin, Giguère Anik, Grad Roland, Granikov Vera, Goulet Serge, Hudon Catherine, Kremer Bernardo, Kröger Edeltraut, Kudrina Irina, Lebouché Bertrand, Loignon Christine, Lussier Marie-Thérèse, Martello Cristiano, Nguyen Quynh, Pratt Rebekah, Rihoux Benoit, Rosenberg Ellen, Samson Isabelle, Senn Nicolas, Tang David L., Tsujimoto Masashi, Vedel Isabelle, Ventelou Bruno et Wensing Michel. (2017). Decisional needs assessment of patients with complex care needs in primary care : a participatory systematic mixed studies review protocol. BMJ Open, 7, (11),

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URL officielle: http://dx.doi.org/10.1136/bmjopen-2017-016400

Résumé

Introduction: Patients with complex care needs (PCCNs) often suffer from combinations of multiple chronic conditions, mental health problems, drug interactions and social vulnerability, which can lead to healthcare services overuse, underuse or misuse. Typically, PCCNs face interactional issues and unmet decisional needs regarding possible options in a cascade of interrelated decisions involving different stakeholders (themselves, their families, their caregivers, their healthcare practitioners). Gaps in knowledge, values clarification and social support in situations where options need to be deliberated hamper effective decision support interventions. This review aims to (1) assess decisional needs of PCCNs from the perspective of stakeholders, (2) build a taxonomy of these decisional needs and (3) prioritise decisional needs with knowledge users (clinicians, patients and managers).

Methods and analysis: This review will be based on the interprofessional shared decision making (IP-SDM) model and the Ottawa Decision Support Framework. Applying a participatory research approach, we will identify potentially relevant studies through a comprehensive literature search; select relevant ones using eligibility criteria inspired from our previous scoping review on PCCNs; appraise quality using the Mixed Methods Appraisal Tool; conduct a three-step synthesis (sequential exploratory mixed methods design) to build taxonomy of key decisional needs; and integrate these results with those of a parallel PCCNs’ qualitative decisional need assessment (semistructured interviews and focus group with stakeholders).

Ethics and dissemination: This systematic review, together with the qualitative study (approved by the Centre Intégré Universitaire de Santé et Service Sociaux du Saguenay-Lac-Saint-Jean ethical committee), will produce a working taxonomy of key decisional needs (ontological contribution), to inform the subsequent user-centred design of a support tool for addressing PCCNs’ decisional needs (practical contribution). We will adapt the IP-SDM model, normally dealing with a single decision, for PCCNs who experience cascade of decisions involving different stakeholders (theoretical contribution). Knowledge users will facilitate dissemination of the results in the Canadian primary care network.

Type de document:Article publié dans une revue avec comité d'évaluation
Volume:7
Numéro:11
Version évaluée par les pairs:Oui
Date:Novembre 2017
Sujets:Sciences de la santé
Sciences de la santé > Sciences infirmières
Sciences de la santé > Sciences médicales
Département, module, service et unité de recherche:Départements et modules > Département des sciences de la santé > Module des sciences infirmières
Mots-clés:Interprofessional care, primary care, shared decision making, decision making, focus groups, health services/utilization, needs assessment, patient participation, primary health care, soins interprofessionnel, soins de premières ligne, prise de décision partagée, prise de décision, soins de santé/utilisation, analyse de besoins, participation du patient, soins de santé primaires
Déposé le:11 déc. 2018 01:52
Dernière modification:11 déc. 2018 01:52
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