ReviewBMC health services research2019
What are the mechanisms that support healthcare professionals to adopt assisted decision-making practice? A rapid realist review.
Review in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Exploring the impact educational interventions have on nursing and medical students' attitudes and empathy levels towards people with disability. A systematic review.Journal of intellectual disabilities : JOID · 2026Pooled it
- Improving healthcare professionals' interactions with patients to tackle antimicrobial resistance: a systematic review of interventions, barriers, and facilitators.Frontiers in public health · 2024Pooled it
- Cultural and Structural Influences on Shared Decision-Making in the Care of Critically Ill Patients with Stroke in China: A Critical Realist Qualitative Study.Neurocritical care · 2026Article
- [Centralization of liver surgery in Germany].Chirurgie (Heidelberg, Germany) · 2026Review
- Methods of Engaging Interest-Holders in Healthcare Evidence Syntheses: A Scoping Review.Cochrane evidence synthesis and methods · 2026Review
- Article
- Assessment of older adults' decision-making capacity for independent living: Findings from a nominal group technique meeting in Ireland.Australian occupational therapy journal · 2025Article
- Perspectives on the essential skills of healthcare decision making in children and adolescents with intellectual disability.International journal for equity in health · 2024Review
- An examination of relational dynamics of power in the context of supported (assisted) decision-making with older people and those with disabilities in an acute healthcare setting.Health expectations : an international journal of public participation in health care and health policy · 2023Article
- Assessing Older Adults' Decision-Making Capacity for Independent Living: Practice Tensions and Complexities.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2022Article
- Discordance and concordance on perception of quality care at end of life between older patients, caregivers and clinicians: a scoping review.European geriatric medicine · 2022Article
- A Rapid Realist Review of Quality Care Process Metrics Implementation in Nursing and Midwifery Practice.International journal of environmental research and public health · 2021Article
- Using a multidisciplinary approach to reveal decision-making capacity within acute care for an individual with aphasia.SAGE open medical case reports · 2021Article
- "International journal of environmental research and public health · 2020Article
- Quality care process metrics (QCP-Ms) in nursing and midwifery care processes: a rapid realist review (RRR) protocol.HRB open research · 2020Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundThe United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) establishes a right to legal capacity for all people, including those with support needs. People with disabilities have a legal right to be given the appropriate supports to make informed decisions in all aspects of their lives, including health. In Ireland, the Assisted Decision-Making (Capacity) Act (2015) ratifies the Convention and has established a legal framework for Assisted Decision Making (ADM). The main provisions of the Act are not yet implemented. Codes of Practice to guide health and social care professionals are currently being developed. Internationally, concerns are expressed that ADM implementation is poorly understood. Using realist synthesis, this study aims to identify Programme Theory (PT) that will inform ADM implementation in healthcare.
methodsA Rapid Realist Review using collaborative methods was chosen to appraise relevant literature and engage knowledge users from Irish health and social care. The review was led by an expert panel of relevant stakeholders that developed the research question which asks, 'what mechanisms enable healthcare professionals to adopt ADM into practice?' To ensure the PT was inclusive of local contextual influences, five reference panels were conducted with healthcare professionals, family carers and people with dementia. PT was refined and tested iteratively through knowledge synthesis informed by forty-seven primary studies, reference panel discussions and expert panel refinement and consensus.
resultsThe review has developed an explanatory PT on ADM implementation in healthcare practice. The review identified four implementation domains as significant. These are Personalisation of Health & ADM Service Provision, Culture & Leadership, Environmental & Social Re-structuring and Education, Training & Enablement. Each domain is presented as an explanatory PT statement using realist convention that identifies context, mechanism and outcome configurations.
conclusionsThis realist review makes a unique contribution to this field. The PT can be applied by policymakers to inform intervention development and implementation strategy. It informs the imminent policy and practice developments in Ireland and has relevance for other worldwide healthcare systems dealing with similar legislative changes in line with UNCRPD.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.