Doença inflamatória intestinal: percepções dos pacientes e dos profissionais de saúde sobre a tomada de decisão compartilhada

Abstract

Abstract Objective To describe perceptions of implementing law 41/2002 on patient autonomy in inflammatory bowel disease patients and professionals in relation to shared decision-making. Methods Qualitative descriptive study using a phenomenological approach. We conduced semi-structured interviews to 10 patients belonging to the Association of Patients with Crohn’s Disease and Ulcerative Colitis in Zamora (Spain) as well as focus group to 7 gastroenterologists and nurses from the ostomy clinic and inpatient gastroenterology unit at the Virgen de la Concha Hospital in Zamora. Data thematic content analysis was performed. Results Two main categories and seven sub-categories emerged: Information (with professionals’ and patients’ knowledge, trust in the professional, time and attitude to information) and Shared decision-making (with attitude to information, coping-resignation and support for decisions). Shared decision-making is a complex process where not only the information is the main value for the patients, but other issues like support, time of illness or emergency are important for patient decision. Conclusion To describe patients’ and professionals’ perceptions of shared decision-making, who saw it as a complex process. To improve the information provided to patients about their illness and their rights can influence participation in shared decision-making and change attitudes. Patients did not permanently adopt an active or passive role in relation to shared decision-making, but instead oscillated between roles depending on multiple factors. Consequently, it is important for health professionals to engage in the process of understanding patients and their needs to facilitate shared decision-making. In addition, greater investment by the authorities is needed to ensure continuity of care and create multidisciplinary inflammatory bowel disease units as measures to improve shared decision-making.