A Qualitative Study On The Acceptance And Associated Factors Of Shared Decision-making By Doctors And Caregivers Of Children With Asthma

Objective:The purpose of this study was to explore the acceptance of shared decision-making by doctors and caregivers of children with asthma and the influencing factors,to understand whether the shared decision-making was suitable for development among children with asthma,and to increase the public’s attention to shared decision-making,to provide evidence for the implementation of shared decision-making in our country.Method:This study adopted descriptive qualitative design,used the purposive sampling method to select participants,including doctors and caregivers of children with asthma from four tertiary A hospitals in Jinan City was collected from May to November in 2020.Data using face to face,semi-structured in-depth interviews.Data was analyzed conventional content analysis.The interview data was sorted and analyzed with the assistance of Nvivo11.0 software.Result:Through in-depth interviews and comprehensive analysis of 18 doctors and 14 caregivers,it was found that the acceptance of shared decision-making by doctors and caregivers and their influencing factors were not the same,and two groups put forward relevant suggestions for accepting shared decision-making.1.Asthma PediatricianThe acceptance of shared decision-making by doctors included four themes:no hearing,idealization,depends on the situation and support.Doctors believed that the factors that influence the acceptance of sharing decision-making have three themes:medical status(tense doctor-patient relationship,multiple patient numbers,network influence,weak power of primary hospitals,time cost),doctor characteristics(communication ability,doctor qualifications)and caregiver characteristics(economic level,cultural education level,disease awareness level,age).doctors’ suggestions for sharing decision-making included five themes:strengthen primary hospitals,establishing asthma specialist clinics,increasing publicity(increasing publicity for shared decision-making,increasing publicity for asthma knowledge),financial subsidies(increasing reimbursement,free provision Asthma medication)and nurse assistance.2.Caregiver for children with asthmaThe acceptance of shared decision-making by caregivers of children with asthma included four themes:no hearing,difficulty in implementation,incomprehension,and acceptance.They believed that the factors that influence the acceptance of sharing decision-making have three themes:medical status(doctor-patient relationship,multiple patient numbers,difficult appointments),doctor characteristics(doctor qualifications,doctor attitude,medical terminology,heavy workload)and caregivers characteristics(age,Lack of knowledge about asthma,psychological factors,misconceptions,attitudes).The recommendations of caregivers of children with asthma for sharing decision-making included five themes:increasing publicity(increasing publicity for shared decision-making,increasing publicity for asthma knowledge),development of key doctors,building patient groups,nurse assistance,and recruiting more doctors.Conclusion:1.In this study,doctors and caregivers of children with asthma interviewed differed in their acceptance of shared decision-making.Both groups had not learned about shared decision-making.However,caregivers of children with asthma were more accepting of shared decision-making than doctors.2.There were three main themes influencing the acceptance of shared decision-making by doctors and caregivers of children with asthma:medical status,characteristics of doctors and characteristics of caregivers.The results of this study could provide a certain reference for follow-up related research.3.Doctors and caregivers of children with asthma had put forward relevant suggestions on the development of shared decision-making,which provided a preliminary basis for promoting shared decision-making in children with asthma.