ArticleBMC health services research2025
Determinants of practice for decision coaching in Germany: a qualitative exploration of decision coaches' perspectives.
Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPatients often want to be involved in decisions about their health. However, to actively participate in the decision-making process and make informed choices, they often require support. Decision coaching can be offered as a non-directive form of decision support provided by trained health care professionals. So far, decision coaching has only been tested in pilot projects in Germany. To investigate the determinants of practice that influence implementation, decision coaches were interviewed in a qualitative study about their practical experiences with decision coaching and regarding facilitators and barriers in its implementation.
methodsGuided expert interviews were conducted from June 2023 to November 2023 with decision coaches from model projects in Germany. The decision coaches were asked about their tasks, work processes, framework conditions, understanding of their role, self-perception, the decision support tools used and barriers and facilitators for the implementation of decision coaching. Sociodemographic data were collected anonymously. The verbatim transcribed interviews were analysed using content analysis according to Kuckartz with MAXQDA. Barriers and facilitators of the implementation of decision coaching were analysed using the Consolidated Framework for Implementation Research (CFIR 2.0) framework.
resultsSeven guided interviews were conducted with experienced female decision coaches (Ø 56 years) from pilot projects in oncology and neurology. While some elements were sustained in practice, only one project continued long-term. Overall, the decision coaches strongly identified with their role and patient acceptance was high. Thematic analysis revealed seven main categories with 32 subcategories. Crucial factors influencing the implementation included structured training, flexible delivery formats, institutional support, dedicated space and funding. Although decision coaching was perceived to enhance patient preparedness and physician-patient communication, structural challenges remain.
conclusionThe coaches perceived their role as supportive in patients’ decision-making. However, the effectiveness and implementation of decision coaching are strongly influenced by several contextual factors that could guide the refinement of interventions and the selection of implementation strategies. CLINICAL TRIAL NUMBER: Not applicable.
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