Facilitators of and barriers to decision-making assistance in patients with age-related macular degeneration: a qualitative study

WAN Junli; BIAN Wei; GUO Wenmei; LIU Mingqiong; ZHANG Feng; WANG Lu

doi:10.16460/j.issn2097-6569.2025.12.036

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Journal of Nursing ›› 2025, Vol. 32 ›› Issue (12) : 36-42. DOI: 10.16460/j.issn2097-6569.2025.12.036

Facilitators of and barriers to decision-making assistance in patients with age-related macular degeneration: a qualitative study

WAN Junli, BIAN Wei, GUO Wenmei, LIU Mingqiong, ZHANG Feng, WANG Lu

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Abstract

Objective To explore the barriers and facilitators in the application of nutritional decision tools for patients with age-related macular degeneration (AMD). Methods Based on the Consolidated for Implementation Research (CFIR 2.0), an interview guide was developed. Using purposeful sampling, 17 healthcare professionals and 11 patients from the ophthalmology department of a tertiary grade-A hospital in Chongqing City were selected for semi-structured interviews between January and June 2024. Results Ten barriers, six facilitators, and five divergent needs between patients and healthcare professionals were identified in the implementation of decision-making assistance for AMD patients. Conclusion This study highlights key barriers and facilitators in implementing decision-making assistance for AMD patients. Future research should focus on optimizing decision tools and workflows to promote adaptive integration of shared decision-making model into clinical practice in China.

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WAN Junli, BIAN Wei, GUO Wenmei, LIU Mingqiong, ZHANG Feng, WANG Lu. Facilitators of and barriers to decision-making assistance in patients with age-related macular degeneration: a qualitative study[J]. Journal of Nursing. 2025, 32(12): 36-42 https://doi.org/10.16460/j.issn2097-6569.2025.12.036

References

[1] Mitchell P, Liew G, Gopinath B, et al.Age-related macular degeneration[J]. Lancet,2018, 392(10153):1147-1159. DOI:10.1016/S0140-6736(18)31550-2.
[2] Wong WL, Su X, Li X,et al.Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and Meta-analysis[J].Lancet Glob Health, 2014, 2(2):e106-e116.DOI:10.1016/S2214-109X(13)70145-1.
[3] Chew EY, Clemons TE,Elvira Agrón,et al.Effect of Omega-3 Fatty Acids, Lutein/Zeaxanthin, or other nutrient supplementation on cognitive function: the AREDS2 randomized clinical trial[J]. JAMA, 2015, 314(8):791-801.DOI:10.1001/jama.2015.9677.
[4] Stevens R, Bartlett H, Cooke R.Evaluation of a clinical decision-making aid for nutrition advice in age-related macular degeneration[J]. Br J Vis Impair,2017,35(3):185-196. DOI:10.1177/0264619616683989.
[5] Madden K, Kleinlugtenbelt YV.Cochrane in CORR®: decision aids for people facing health treatment or screening decisions[J]. Clin Orthop Relat Res, 2017, 475(5):1298-1304. DOI:10.1007/s11999-017-5254-4.
[6] 万君丽,张凤,郭文梅,等. 年龄相关性黄斑变性患者营养干预决策辅助方案的构建及应用[J]. 中华护理杂志,2022,57(23):2870-2876.DOI:10.3761/j.issn.0254-1769.2022.23.008.
[7] 张兰萍,吕森森,何文俊,等. 实施性研究综合框架(CFIR)更新版的解析和应用[J]. 护理学报,2023,30(11):47-52. DOI:10.16460/j.issn1008-9969.2023.11.047.
[8] Lindgren BM, Lundman B, Graneheim UH.Abstraction and interpretation during the qualitative content analysis process[J].Int J Nurs Stud,2020,108:103632.DOI:10.1016/j.ijnurstu.2020.103632.
[9] 葛莉,黄萍萍,王冠东,等. 质性内容分析方法与质量控制[J]. 护士进修杂志,2021,36(9):857-860.DOI:10.16821/j.cnki.hsjx.2021.09.022.
[10] Spatz ES, Krumholz HM, Moulton BW.The new era of informed consent: getting to a reasonable-patient standard through shared decision making[J]. JAMA, 2016,315(19):2063-4.DOI:10.1001/jama.2016.3070.
[11] Kaplan SA.Re:Evaluating Shared Decision Making for Lung Cancer Screening[J]. J Urology, 2019, 201(1):5-6.DOI:10.1097/01.ju.0000550101.33034.8d.
[12] 徐梦阳,张莉,陈亚伟,等.医生对医患共同决策选择倾向性研究[J].医学与哲学, 2019(6):4.
[13] Joseph-Williams N, Lloyd A, Edwards A,et al.Implementing shared decision making in the NHS: lessons from the MAGIC programme[J].BMJ, 2017:j1744.DOI:10.1136/bmj.j1744.
[14] 魏小雪,欧阳丰,刘杨,等. 超重和肥胖患者体质量控制促进和障碍因素的系统评价:基于实施性研究综合框架[J]. 护理学报,2024,31(23):66-72. DOI:10.16460/j.issn1008-9969.2024.23.066.
[15] Yao M, Finnikin S, Cheng KK.Call for shared decision making in China: Challenges and opportunities[J]. Z Evid Fortbild Qual Gesundhwes,2017(123/124):32-35. DOI:10.1016/j.zefq.2017.05.004.
[16] 何清新,夏文芳.医患共同决策面临的问题及解决方法探索[J].医学与哲学, 2023, 44(5):18-20.DOI:10.12014/j.issn.1002-0772.2023.05.04.
[17] Berger-Höger B, Liethmann K, Mühlhauser I,et al.Nurse-led coaching of shared decision-making for women with ductal carcinoma in situ in breast care centers: a cluster randomized controlled trial[J]. Int J Nurs Stud, 2019,93:141-152. DOI:10.1016/j.ijnurstu.2019.01.013.
[18] Strachan PH, Kryworuchko J, Nouvet, Elysée,et al.Canadian hospital nurses’ roles in communication and decision-making about goals of care: an interpretive description of critical incidents[J].Applied Nursing Research, 2018, 40:26-33.DOI:10.1016/j.apnr.2017.12.014.
[19] 宋莹婵茜,杨青,文彦.基于CFIR框架的“医院-社区-家庭”联动下癌痛患者居家护理促进和障碍因素的质性研究[J].护士进修杂志, 2023, 38(21):2010-2015.
[20] Fattori F, Zisman-Ilani Y, Chmielowska M, et al.Measures of shared decision making for people with mental disorders and limited decisional capacity: a systematic review[J]. Psychiatr Serv,2023, 74(11):1171-1175. DOI:10.1176/appi.ps.202200018.
[21] 陈晶晶,田曼. 浅析医患共同决策面临的问题及出路[J]. 医学与哲学,2018, 39(7):10-12,20. DOI:10.12014/j.issn.1002-0772.2018.04a.03.
[22] Hoffmann T, Bakhit M, Michaleff Z.Shared decision making and physical therapy: what, when, how, and why?[J].Braz J Phys Ther ,2022, 26(1):100382. DOI:10.1016/j.bjpt.2021.100382.
[23] Hawkins AT, Fa A, Younan SA, et al.Decision aid for colectomy in recurrent diverticulitis: development and usability study[J]. JMIR Form Res,2024, 8:e59952. DOI:10.2196/59952.
[24] Lee SH, Park YI, Choi CB, et al.Usability and understandability of a web-based medical communication aid for patients with ankylosing spondylitis in South Korea: a mixed-methods study[J].Medicine, 2023, 102(14):e33430.DOI:10.1097/MD.0000000000033430.