Abstract
Background: Shared decision-making (SDM) implementation is a priority for Australian health systems, including general practices but it remains complex for specific groups like older rural Australians. We initiated a qualitative study with older rural Australians to explore barriers to and facilitators of SDM in local general practices. Methods: We conducted a patient-oriented research, partnering with older rural Australians, families, and health service providers in research design. Participants who visited general practices were purposively sampled from five small rural towns in South Australia. A semi-structured interview guide was used for interviews and reflexive thematic coding was conducted. Results: Telephone interviews were held with 27 participants. Four themes were identified around older rural adults’ involvement in SDM: (1) Understanding of “patient involvement”; (2) Positive and negative outcomes; (3) Barriers to SDM; and (4) Facilitators to SDM. Understanding of patient involvement in SDM considerably varied among participants, with some reporting their involvement was contingent on the “opportunity to ask questions” and the “treatment choices” offered to them. Alongside the opportunity for involvement, barriers such as avoidance of cultural care and a lack of continuity of care are new findings. Challenges encountered in SDM implementation also included resource constraints and time limitations in general practices. Rural knowledge of general practitioners and technology integration in consultations were viewed as potential enablers. Conclusion: Adequate resources and well-defined guidelines about the process should accompany the implementation of SDM in rural general practices of South Australia. Innovative strategies by general practitioners promoting health literacy and culturally-tailored communication approaches could increase older rural Australians’ involvement in general.
| Original language | English |
|---|---|
| Pages (from-to) | 140-146 |
| Number of pages | 7 |
| Journal | Global Health Journal |
| Volume | 8 |
| Issue number | 3 |
| Publication status | Published - Sept 2024 |
Funding
We are thankful to the participants who provided time and shared their experiences about their GP visits. We acknowledge the contribution of Renmark Rotary Club which helped the researchers in distributing the survey questionnaire and encouraging local older adults and their families to participate. Team thanks go to Dr Judy Bailey who supported researchers by conducting interviews with participants. The author(s) disclosed receipt of the following research grant for this project: Research was financed by the Flinders University College of Business, Government and Law Large Project Grant (Grant number: 100031.21). The datasets generated during this study are not publicly available due to the sensitive and personal nature of the information contained in the data. Data may be available from the corresponding author, with restrictions and following ethical approval. The study received ethics approval from Flinders University Human Research Ethics Committee, Australia (Project number: HREC8252). All informants gave audio recorded verbal consent to participate prior to interviews. The author(s) disclosed receipt of the following research grant for this project: Research was financed by the Flinders University College of Business, Government and Law Large Project Grant [Grant Number: 100031.21 ].
| Funders | Funder number |
|---|---|
| Renmark Rotary Club | |
| Flinders University College of Business, Government and Law Large | HREC8252, 100031.21 |
Keywords
- General practices
- Older rural Australians
- Patient involvement
- Shared decision making
- South Australia
ASJC Scopus subject areas
- General Medicine