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Health literacy

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Indecisive

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Patients who lack insight or health literacy 

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Patients who lack insight or health literacy 

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Family members not with them to listen and decide 

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Family members not with them to listen and decide 

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Maybe is not impt

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Willingness to engage

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Ensuring that the objectives from the different healthcare professionals are aligned and not to further confused pt/nok

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Different opinions

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Patient refuses to open up

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Pt/family sometimes can get frustrated when they keep repeating themselves because HCW kept asking them similar questions. Sometimes then difficult to engage them further

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Practitioner's time

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the need to build rapport with the patients

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resistance from patients and family members

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resistance from patients and family members

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Establishing the understanding and congruence at the time of discussion 

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Establishing the understanding and congruence at the time of discussion 

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Difference in expectation of the outcome of the conversation between patient and HCP

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expect HCP to know best and give solutions and decide for them 

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expect HCP to know best and give solutions and decide for them 

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difficulty aligning everyone

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Limited health literacy of patient and family

Language barriers

Difficult to get the key stakeholders together at the same time and same location

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Taboo topic. Not wanting to talk abt disease /condition

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allowing space for emotions to be expressed

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How to deliver the information correctly and ensure their understanding 

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How to deliver the information correctly and ensure their understanding 

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Challenging. Because a lot of times patient would say that would prefer to Dr to make a decision for them. Or for children to make a decision for them.

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Readiness to discuss about the illness

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Many of a times they leave decision making to their family members

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Patient is not ready

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Some patients prefer a more paternalistic approach, others have very high information needs but are mistrustful of medical opinions

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Want hcp to decide for them

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Barriers in communication...  Language, impaired hearing, etc

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Barriers in communication...  Language, impaired hearing, etc

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Reluctant to share

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How forthcoming are they to disclose/ broach these hurdles 

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How forthcoming are they to disclose/ broach these hurdles 

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Patient is hesitate to express their thoughts but rather what the family wants

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It should be more paternalistic as patients go through this journey once but as physicians we see the same condition many times. Hence, we may be in a better position to advise them on certain things or push them towards a certain direction. Hahhaaa. So sometimes shared decision making is tough

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It should be more paternalistic as patients go through this journey once but as physicians we see the same condition many times. Hence, we may be in a better position to advise them on certain things or push them towards a certain direction. Hahhaaa. So sometimes shared decision making is tough

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Health literacy and simplifying to recipient's understanding 

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Health literacy and simplifying to recipient's understanding 

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Health believes.. they rather believe Dr google.

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Pt’s Personality - don’t want to think of the future, want to face it only when it comes

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It is hard when we talk together about shared decision making, the patient some time say that "I dont know anything, please just do whatever you think is best" 

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It is hard when we talk together about shared decision making, the patient some time say that "I dont know anything, please just do whatever you think is best" 

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Medical: Prognostic uncertainity, clinically unwell, poor insight into own health

Systemic: place of documentation for continued discussions

Patient factors: understanding of own health, “not ready”

Language barrier

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There is confliction in decision making between pt and families 

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There is confliction in decision making between pt and families 

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Some believe their friends/coffeeshop kakis only

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Some believe their friends/coffeeshop kakis only

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Patient feels that doctor should be the one recommending 

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Patient feels that doctor should be the one recommending 

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The relationship with patients plays an important role as well for effective communication 

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The relationship with patients plays an important role as well for effective communication 

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Old wives's tales and cultural differences 

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Old wives's tales and cultural differences 

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Patients may think there’s only one right way to do things and expect the doctor to tell them what it is