Article type
Year
Abstract
Background: Adoption of shared decision making (SDM) requires behaviour changes in health professionals. The Theory of Planned Behaviour (TPB) widely used to provide theoretical underpinnings for understanding such behavioural changes.
Objectives: We systematically reviewed studies that used the TPB to assess SDM-related clinical behaviours in health professionals.
Methods: We searched PsycINFO, MEDLINE, EMBASE, CINAHL, Index to Theses, ProQuest dissertations and Current Contents for all years up to April 2012. The search terms were (Planned behaviour OR intention) AND (Health professional). We included all studies in French or English that used the TPB and/or the TRA to assess SDM behavioural intentions or performance of behaviours in health professionals. We extracted study characteristics, type of SDM behaviour based on theMakoul & Clayman integrative SDM model, and theory-based determinants of the SDM behaviour.
Results: Out of 12 388 titles, we assessed 136 full-text articles for eligibility. We kept 20 eligible studies, all published in English between 1996 and 2012 (Cohen’s kappa = 0.78). Studies were conducted in Canada (n=8), the USA (n=6), the Netherlands (n=3), the United Kingdom (n=2) and Australia (n=1). The SDM behaviours most often measured in a clinical context were ‘sharing knowledge and making recommendations’ (n = 9) and ‘clarifying the patient’s values and preferences’ (n = 8). The most frequently reported psychosocial determinants of the intention to perform a behaviour were subjective norm (n = 11), perceived behavioural control (n = 11) and attitude (n = 10). Six studies measured behaviour alongside intention. Great variability was observed in regression coefficients between psychosocial variables and theoretical constructs of intention (range = 0.05–0.75) and behaviour (range = 0.28–0.56).
Conclusions: The TPB is a valid theoretical framework for understanding health professionals’ behaviour in the context of SDM. Further research is needed to understand how intention is linked to behavioural change in this context.
Objectives: We systematically reviewed studies that used the TPB to assess SDM-related clinical behaviours in health professionals.
Methods: We searched PsycINFO, MEDLINE, EMBASE, CINAHL, Index to Theses, ProQuest dissertations and Current Contents for all years up to April 2012. The search terms were (Planned behaviour OR intention) AND (Health professional). We included all studies in French or English that used the TPB and/or the TRA to assess SDM behavioural intentions or performance of behaviours in health professionals. We extracted study characteristics, type of SDM behaviour based on theMakoul & Clayman integrative SDM model, and theory-based determinants of the SDM behaviour.
Results: Out of 12 388 titles, we assessed 136 full-text articles for eligibility. We kept 20 eligible studies, all published in English between 1996 and 2012 (Cohen’s kappa = 0.78). Studies were conducted in Canada (n=8), the USA (n=6), the Netherlands (n=3), the United Kingdom (n=2) and Australia (n=1). The SDM behaviours most often measured in a clinical context were ‘sharing knowledge and making recommendations’ (n = 9) and ‘clarifying the patient’s values and preferences’ (n = 8). The most frequently reported psychosocial determinants of the intention to perform a behaviour were subjective norm (n = 11), perceived behavioural control (n = 11) and attitude (n = 10). Six studies measured behaviour alongside intention. Great variability was observed in regression coefficients between psychosocial variables and theoretical constructs of intention (range = 0.05–0.75) and behaviour (range = 0.28–0.56).
Conclusions: The TPB is a valid theoretical framework for understanding health professionals’ behaviour in the context of SDM. Further research is needed to understand how intention is linked to behavioural change in this context.