Exploring the role of patient activity in the clinical decision-making processes of health care practitioners working in hospital care: A qualitative study

Abstract

ObjectiveThis study aims to explore the role of patient activity in the clinical decision-making processes of various health care practitioners working in hospital care.DesignQualitative research study.SettingThe study was conducted in the hospital care setting of UMC Utrecht, the Netherlands.ParticipantsHealth Care Practitioners working in the hospital setting were selected through purposive sampling. Doctors, nurses, and physiotherapists were included if their professional activity centered on inpatient care, they had worked in the hospital for over four weeks and were not students in the department.Main measuresData were collected through observations and interviews. Interview recordings were transcribed, and both the interview transcripts and observation fieldnotes were coded and analyzed using reflexive thematic analysis, following Braun and Clarke's approach. Themes were iteratively reviewed and refined, leading to the development of core themes, which were constructed by synthesizing subthemes and examining their interrelationships.ResultsThe study involved forty-two participants working at UMC Utrecht. Four core themes were identified: 1) Patient activity influences clinical decision-making, 2) clinical decision-making influences patient activity, 3) multidisciplinary dynamics influence how patient activity is valued in clinical decisions, and 4) limited use of objective measurements influences how patient activity informs clinical decisions.ConclusionThis study explores the complex interaction between clinical decision-making and patient activity and how patient activity is integrated from a multidisciplinary perspective in the hospital setting. The results highlight the importance of interdisciplinary communication, barriers and facilitators for improved decision-making and examines both implicit and explicit processes involved.