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Table 4 HCPs’ perceptions of the strengths of the Decision Boxes

From: User-centered and theory-based design of a professional training program on shared decision-making with older adults living with neurocognitive disorders: a mixed-methods study

Themes and Subthemes

Illustrative citation*

Visual design

Good visual design

“Very nice tool with an excellent visual presentation.” (Physician #22, Round #1, DB #3) ; “Well-designed tool. Easy to use.” (Physician #31, Round #2, DB #3)

Tabular format: tables are very clear and visual

“Very clear, visually appealing tables. The Confidence in these results pictograms could be a bit more visible (black dots rather than a cross? Bigger circles?). The presentation page (page 1) is a bit dry to read, but essential for explaining the goal.” Physician #12, Round #1, DB #1)

Balance between benefits and harms is useful

“Nice layout of benefits vs harms.” (Physician #74, Round #4, DB #2)

Informational content

 

Value of the information about the options

“The box presents some very interesting options.” (Physician #32, Round #3, DB #1)

Raises awareness about certain options

“The role of case manager no longer exists in many CLSCs. Highly relevant and appropriate for our family caregivers who are unsure or unaware of which resources to turn to. I will definitely use it.” (Social worker #12b, Round #4, DB #1) ; “Great idea for improving our client service.” (Social worker #48, Round #4, DB #4)

Information allows HCPs to keep up-to-date and to empower patients

“Nice tool that allows us to be more professional and access up-to-date knowledge. Also enables us to show that we respect the client’s values. Helps empower them.” (Social worker #48, Round #4, DB #1)

A tool to help older adults realize themselves their own risks

“Very interesting toolbox for guiding and helping patients realize on their own that their driving may not be safe, instead of having the impression, as a doctor, that you are taking away their license and their autonomy. It helps maintain the quality of the therapeutic relationship.” (Physician #36b, Round #4, DB #3)

Useful to remind me of something I already know

“The information in the box will be helpful for refreshing my memory on the various power of attorney options.” (Physician #31, Round #1, DB #5)

Implementation of SDM

 

Useful to adopt a shared decision-making approach in their practice

“I have never (or rarely) discussed stopping driving with a patient based on the risks and benefits to the patient. Rather, I tried to test the patient's skills through tests without necessarily dwelling on his understanding of the risks of driving. Participation in this study will make me more likely to approach the risk-benefit aspect with the patient in the future.” (Physician #12, Round #3, DB #3)

  1. *DB #1 = Choosing a support option to decrease caregiver burden; DB #2 = Choosing a non-pharmacological treatment to manage agitation, aggression, or psychotic symptoms; DB #3 = Deciding whether or not to stop driving following diagnosis; DB #4 = Choosing an option to improve quality of life; DB #5 = Deciding whether or not to prepare a power of attorney.