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The theory of planned behaviour applied to shared decision making behaviours: a systematic review

Date and Location

Session: 

P2.098

Date

Saturday 21 September 2013 - 10:30 - 12:00

Location

Presenting author and contact person

Presenting author

Philippe Thompson...

Contact person

France Légaré
Abstract text
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 the Makoul & 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 to 0.75) and behaviour (range = 0.28 to 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.