Shared Decision-Making in Hemophilic Arthropathy Rehabilitation: A Qualitative Study

Patient Prefer Adherence. 2023 Jan 25:17:249-257. doi: 10.2147/PPA.S394095. eCollection 2023.

Abstract

Purpose: To probe into the needs and barriers underlying patients' participation in shared decision-making related to rehabilitation nursing for hemophilic arthropathy.

Patients and methods: The phenomenological research approach was adopted to conduct a series of semi-structured, in-depth interviews with 15 patients with hemophilic arthropathy undergoing rehabilitative treatments, 10 caregivers, and 7 healthcare providers from a hemophilia treatment center in Shanxi province, China. Colaizzi's seven-step method of data analysis was applied to organize, analyze, and extract the themes from the interview materials.

Results: Three main themes emerged from the analysis: the status quo of the healthcare system (insufficient decision support systems and mismatch between healthcare providers' and patients' resources), circumstances of provider-patient interactions (lack of information exchange and unbalanced power structure between healthcare providers and patients), and patient-related factors influencing participation in decision-making (lack of self-efficacy, personal characteristics, family and social decision support, and attitude toward participation in decision-making).

Conclusion: Participation in rehabilitation decision-making among patients with hemophilic arthropathy is affected by multiple barriers. Healthcare professionals should improve their understanding of shared decision-making, offer patients active guidance on participating in the decision-making process, prioritize their affective needs, and formulate professional and effective solutions to support shared decision-making as early as possible.

Keywords: hemophilic arthropathy; joint function; nursing; qualitative research; rehabilitation program; shared decision-making.

Grants and funding

This study has been conducted through a project grant from the Scientific Research Foundation for Doctoral Programs of Shanxi University of Chinese Medicine, grant no.: 2020BK16.