Cancer Medicine (Oct 2024)

Barriers and facilitators of healthcare professionals in integrating shared decision‐making in pancreatic cancer treatment: A network approach

  • Joannes Franciscus Adrianus Gerardus vanBroekhoven,
  • Fleur Arda Servasa vanHeesch,
  • Sasja Mulder,
  • Rosella Hermens,
  • Philip van derWees,
  • Marion van derKolk

DOI
https://doi.org/10.1002/cam4.70218
Journal volume & issue
Vol. 13, no. 19
pp. n/a – n/a

Abstract

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Abstract Purpose Shared decision‐making (SDM) is crucial in pancreatic cancer treatment due to its choice‐sensitive nature and limited prognosis. Treatment of pancreatic cancer is organized in a network approach. Several obstacles exist on different levels—patient, healthcare professional, organizational, societal—that impede integration of SDM. This study aims to identify barriers and facilitators to SDM implementation within a comprehensive cancer network. Methods A qualitative research design was applied, involving interviews and focus groups on barriers and facilitators with healthcare professionals involved in the implementation of SDM. In one comprehensive cancer network in the Netherlands, including seven hospitals, a project was initiated with the goal of empowering patients and healthcare professionals in SDM throughout primary, secondary and tertiary healthcare settings. A total of 17 participants were assessed. Directed qualitative content analysis was performed by two researchers. Results Main findings revealed barriers such as time constraints, lack of priority of physicians, little involvement of general practitioners, and insufficient social context of patients in referrals, alongside facilitators including learning communities with practical SDM examples, metro mapping, involvement of case manager in implementation and patient empowerment strategies. Conclusion Addressing cultural, systemic barriers and developing innovative strategies are of importance to enhance SDM in pancreatic cancer treatment in a network approach. This study provides understanding of SDM implementation in complex healthcare settings and offers valuable guidance for future interventions seeking to improve decision‐making processes in pancreatic cancer treatment and beyond.

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