Evidence map›Paper›PMID 41338614›Full record

ArticleBMJ open2025

Attitudes towards addressing environmental sustainability in patient-provider interactions: a qualitative study among Dutch physicians.

Eva S Cohen, Fleur Grandiek, Dionne S Kringos, Lisanne H J A Kouwenberg, Nicolaas H Sperna Weiland, Cristina Richie, Johanna W M Aarts, Wouter J K Hehenkamp

Abstract read
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Eva S CohenDepartment of Obstetrics and Gynaecology, Amsterdam University Medical Centre, Amsterdam, The Netherlands e.s.cohen@amsterdamumc.nl.ORCID http://orcid.org/0000-0002-9679-8875
Fleur GrandiekDepartment of Obstetrics and Gynaecology, Amsterdam University Medical Centre, Amsterdam, The Netherlands.
Dionne S KringosCentre for Sustainable Healthcare, Amsterdam University Medical Centre, Amsterdam, The Netherlands.
Lisanne H J A KouwenbergCentre for Sustainable Healthcare, Amsterdam University Medical Centre, Amsterdam, The Netherlands.
Nicolaas H Sperna WeilandCentre for Sustainable Healthcare, Amsterdam University Medical Centre, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0003-1305-1846
Cristina RichieDepartment of Philosophy, The University of Edinburgh, Edinburgh, UK.
Johanna W M AartsDepartment of Obstetrics and Gynaecology, Amsterdam University Medical Centre, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0002-0674-9405
Wouter J K HehenkampDepartment of Obstetrics and Gynaecology, Amsterdam University Medical Centre, Amsterdam, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo investigate the attitudes of physicians towards addressing environmental sustainability in patient conversations, and to identify barriers and facilitators to doing so.

designA qualitative, nation-wide study was conducted using semi-structured online focus groups and interviews. Reflexive thematic analysis was used to analyse transcripts, guided by the Theoretical Domains Framework.

settingSecondary and tertiary healthcare institutions in the Netherlands.

participantsParticipants were medical specialists and residents in obstetrics and gynaecology (OB-GYN physicians) in the Netherlands. Participants were purposefully identified to capture diverse demographics and practice settings. PRIMARY AND SECONDARY OUTCOME MEASURES: Physicians' attitudes towards discussing the environmental impact of healthcare and the health effects of environmental pollution with patients. Themes were identified and categorised using the Theoretical Domains Framework.

resultsThe study included 28 OB-GYN physicians working across 23 healthcare institutions in the Netherlands. Six themes were developed: (1) strong sense of urgency to reduce healthcare's environmental impact, (2) knowledge gaps impair communication about environmental impact to patients, (3) prioritisation of individual patient health over environmental concerns in decision-making, (4) perceived lack of patient interest in environmental outcomes, (5) system-level support facilitates discussions about environmental sustainability with patients and (6) limited perceived value in discussing the health effects of environmental pollution and climate change with patients.

conclusionsOB-GYN physicians are supportive of discussing the environmental impact of healthcare services when clinically appropriate. Addressing knowledge gaps, providing evidence-based guidance and embedding sustainability into clinical guidelines and decision aids may facilitate the integration of environmental sustainability into patient-provider interactions.

Indexed as

Attitude of Health PersonnelConservation of Natural ResourcesPhysician-Patient RelationsPhysiciansAdultCommunicationFemaleFocus GroupsGynecologyHumansMaleMiddle AgedNetherlandsObstetricsQualitative ResearchClimate ChangeClinical Decision-MakingGYNAECOLOGYHealth ServicesPatient-Centered CareQUALITATIVE RESEARCH

Identifiers

PMID41338614
PMCPMC12682203

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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.