Dunja Dreesens

123 General discussion The general discussion first restates the aims and research questions of this thesis. Second, it provides an overview of the study results in the main findings. The strengths and limitations of this thesis are described next. After that, I will return to the concerns as described in the (worlds of the) introduction while reflecting on the main findings and compare these findings to other research. Finally, I present the conclusions on tools and knowledge, the needs of healthcare professionals, and recommendations for practice, research and policy. Aim& research questions Knowledge in health care is vast and accumulating fast. Next to knowledge from scientific research, data and knowledge from clinical practice and on patient preferences, experiences and outcome are becoming more readily available. To make all this knowledge available to healthcare professionals and patients in a timely matter and in such a way that it is easy to digest and apply, tools are developed. These tools support knowledge translation and (shared) decision-making. Knowledge translation is “the synthesis, dissemination, exchange, and ethically sound application of knowledge to improve health, provide more effective health services and products, and strengthen the healthcare system” (292). Shared decision-making (SDM) is defined as “an approach where clinicians and patients share the best available evidence when faced with the task of making decisions, and where patients are supported to consider options, to achieve informed preferences” (293). The aim of this thesis was fourfold. Firstly, in the domains of health care (curative, palliative care, long term care and public health) tool types are no longer developed without a clear definition and use (chapters 2 and 3). Secondly, there exists a common terminology when referring to tool types (chapters 3 and 4). Thirdly, to make better use of the different knowledge sources available (chapter 5), and finally provide healthcare professionals and patients, and possibly other users such as policy advisors and insurers, with a set of pragmatic tools that cover their needs in knowledge translation and decision support (chapters 3 and 6). The following research questions were formulated: 1. What tool types to translate knowledge and support (shared) decision-making are available to healthcare professionals (and patients) in the Netherlands? (Chapter 2) 2. How are these tool types defined and does consensus exist on the definitions across the healthcare domains in the Netherlands? (Chapters 2 and 3) 3. Which criteria do these tool types need to meet and which purposes do they serve so that healthcare professionals and patients consider them trustworthy and useful? (Chapter 4) 4. Do we consider all knowledge sources when developing tools, and what does that mean for tool development? (Chapter 5) 5. What are healthcare professionals’ needs using tools for knowledge translation and shared decision-making? (Chapter 6) Chapter 7