A qualitative study of professional and client perspectives on information flows and decision aid use

A secondary analysis was undertaken of qualitative data collected as part of a larger study. The data included twelve interviews with carers of people with dementia, three interviews with expert advisors, and three focus groups with health professionals. A theoretical analysis was conducted, drawing on theories of 'positioning' and professional identity.Health professionals are seen to hold varying attitudes and beliefs about carers' decision support needs, and these appeared to be grounded in the professional identity of each group. These attitudes and beliefs shaped their attitudes towards decision aids, the information they believed should be offered to dementia carers, and the timing of its offering. Some groups understood carers as needing to be protected from realistic information and consequently saw a need to filter information to carer clients.Health professionals' beliefs may cause them to restrict information flows, which can limit carers' ability to make decisions, and limit health services' ability to improve partnering and shared decision making. In an era where information is freely available to those with the resources to access it, we question whether health professionals should filter information.Shared decision making between health professionals and clients is now recognized as an imperative for improving primary health care outcomes [1]. Decision support needs and factors facilitating decision partnerships are, however, complex and contextual and it is increasingly clear we need to better understand this complexity [2-6]. Decision aids (DAs) are known to help individuals to make health care choices in complex situations, and when outcomes may be indeterminate or dependent on values and beliefs [7]. However, many research questions remain to be answered as to how DAs work in different settings, and in particular what influence diverse professional cultures might exert on the success or otherwise of decision aids targeting health service consumers