Journal
KIDNEY RESEARCH AND CLINICAL PRACTICE
Volume 41, Issue 2, Pages 242-252Publisher
KOREAN SOC NEPHROLOGY
DOI: 10.23876/j.krcp.21.071
Keywords
Clinical decision-making; End-of-life care; Life-sustaining treatment; Patient-centered care; Physician preference; Shared; decision-making
Categories
Funding
- Korean Society of Nephrology
- Soonchunhyang University Research Fund
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Despite the use of shared decision-making (SDM) in practice, physicians in Korea believe that it is not being implemented properly. Lack of time, educational materials, and training on SDM are identified as the main obstacles to its appropriate application.
Background: Evidence of the ethical appropriateness and clinical benefits of shared decision-making (SDM) are accumulating. This study aimed to not only identify physicians' perspectives on SDM, and practices related to end-of-life care in particular, but also to gauge the effect of SDM education on physicians in Korea. Methods: A 14-item questionnaire survey using a modified Delphi process was delivered to nephrologists and internal medicine trainees at 17 university hospitals. Results: A total of 309 physicians completed the survey. Although respondents reported that 69.9% of their practical decisions were made using SDM, 59.9% reported that it is not being applied appropriately. Only 12.3% of respondents had received education on SDM as part of their training. The main obstacles to appropriate SDM were identified as lack of time (46.0%), educational materials and tools (29.4%), and education on SDM (24.3%). Although only a few respondents had received training on SDM, the proportion of those who thought they were using SDM appropriately in actual practice was high; the proportion of those who chose lack of time and education as factors that hindered the proper application of SDM was low. Conclusion: The majority of respondents believed that SDM was not being implemented properly in Korea, despite its use in actual practice. To improve the effectiveness of SDM in the Korean medical system, appropriate training programs and supplemental policies that guarantee sufficient application time are required.
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