Dunja Dreesens

113 same opinions. However, data saturation occurred after the eight interviews. Another limitation was the timing of the interviews; in hindsight, the interviews might have taken place too early as the guideline PCFC had not been fully implemented yet. Which meant that most of the participants had not used the guideline yet, and some had only heard of it. This was countered by showing the participants the guideline and by walking through the recommendations on SDM. Key strengths were that we conducted the research with the developers of the PCFC guideline themselves (EV, LK) and that participants were very forthcoming and open during the interviews as they were being interviewed by a doctor to be. We also carried out a member check on the interview transcripts. Conclusions The interviews showed that most of the participants thought that CPGs in general potentially could enhance SDM. However, integrating SDM into a guideline seems not to be an easy feat, and guideline developers have to walk a tightrope on how to formulate recommendations on SDM. They have to avoid stating the obvious because it might offend and alienate the pediatrician. At the same time, they have to provide more detail on how to practice SDM. Furthermore, developers could consider formulating more ‘open’ recommendations. Especially in case of preference sensitive choices, the recommendation should describe (treatment) trade- offs and (treatment) alternatives and provide more detailed guidance. Another consideration is to provide tools amalgamated with specific guideline recommendations that enhance SDM, such as PDAs. Acknowledgements We would like to thank all interviewed pediatricians for their input, openness and time. Especially, we would also like to express our thanks to Wim Tissing, MD (UMC Groningen, the Netherlands) and Astrid Heijnen (UMC Groningen) for their support in organizing the interviews. No conflicts of interest to report. Chapter 6