Dunja Dreesens

23 Moreover, how do we best disclose the knowledge and the tools? Compared to the 20 th century, there are much more opportunities now with the internet and ICT. The aim of this PhD-research is fourfold. Firstly, tool types are no longer developed without a clear definition and use. Secondly, there exists a common terminology when referring to tool types. Thirdly, to make better use of the different knowledge sources available, and finally provide healthcare professionals and patients, and possibly other users such as policy advisors and insurers, with a set of pragmatic tools that covers their needs in knowledge translation and (shared) decision support. This has led to the following research questions: 1. What tool types to translate knowledge and support (shared) decision-making are available to healthcare professionals (and patients) in the Netherlands? 2. How are these tool types defined and does consensus exist on the definitions across the healthcare domains in the Netherlands? 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? 4. Do we consider all knowledge sources when developing tools, and what does that mean for tool development? 5. What are healthcare professionals’ needs using tools for knowledge translation and shared decision-making? Outline of thesis This thesis exists of several chapters. After this introduction, the second chapter describes the results of the scoping review into tool types available to healthcare professionals and patients that support knowledge transfer and (shared) decision-making (research question 1 and 2). The Delphi study carried out after the review aimed to limit the number of tool types and to achieve national consensus on the definitions of these tools and is covered in chapter three (research question 2 and 3). Chapter four presents the conceptual framework on patient-directed knowledge tools – detailing purposes and core elements of these tools – which was developed by a group of international experts during a consensus-based evidence informed meeting (research question 3). Chapter five explores the different kinds of knowledge being used in clinical practice guidelines and how this affects, or should affect the development of clinical practice guidelines (research question 4). In chapter six, interviewed paediatricians reflect firstly on the clinical practice guideline ‘Palliative care for children’ that attempted to integrate shared decision-making into the guideline, and secondly on other strategies in which guidelines can be adapted to enhance shared decision-making (research question 5). Finally, chapter seven provides a summary of findings and contains the general discussion addressing the outcomes and implications for daily practice, as well as suggestions for future research. Chapter 1