What question did this study set out to answer?

To synthesize multilevel barriers and facilitators to implementing shared decision making (SDM) in postmastectomy breast reconstruction and identify strategies that improve decision quality, patient experience, and equity.

August 19, 2026Medical Decision Making

Bridging the Gap between Intent and Implementation: A Mixed-Methods Systematic Review of Barriers and Enablers of Shared Decision Making in Postmastectomy Breast Reconstruction

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Authors

MMMarta Maes‐Carballo LSLaura Sampol-Ramírez NDNatalia de-la-Puente-Mota

Discussion

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Overview

Mixed-methods systematic review reveals shared decision making improves patient knowledge in postmastectomy reconstruction, indicating multilevel implementation challenges remain.

Key Points

To synthesize multilevel barriers and facilitators to implementing shared decision making (SDM) in postmastectomy breast reconstruction and identify strategies that improve decision quality, patient experience, and equity.
PRISMA 2020-guided mixed-methods systematic review preregistered on OSF, searching six databases (PubMed, Embase, Scopus, Web of Science, Cochrane Library, Trip Database) from inception to November 2025.
Included qualitative, quantitative, and mixed-methods studies (sample sizes ranging from 15 to 485 participants) across North America, Europe, and Asia, synthesizing data via a convergent integrated approach mapped to the Consolidated Framework for Implementation Research.
Interventions such as decision aids, digital tools, and preconsultation education increased patient knowledge by +6% to 32%, decreased decisional conflict by 13 to 25 points, and reduced consultation time by up to 41%.
Key facilitators spanned individual clinician engagement, organizational multidisciplinary collaboration, and macro-level supportive strategies, whereas primary barriers included limited health literacy, workflow constraints, inadequate documentation, and structural inequities.

Cite This Study

Maes‐Carballo et al. (2026) studied this question.

synapsesocial.com/papers/6a8563d703308d306e2d74a7 https://doi.org/10.1177/0272989x261473627

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August 19, 2026Medical Decision Making

Bridging the Gap between Intent and Implementation: A Mixed-Methods Systematic Review of Barriers and Enablers of Shared Decision Making in Postmastectomy Breast Reconstruction

View Full Paper

Ask AI

Bookmark

Authors

MMMarta Maes‐Carballo LSLaura Sampol-Ramírez NDNatalia de-la-Puente-Mota

Discussion

Member takes

Overview

Mixed-methods systematic review reveals shared decision making improves patient knowledge in postmastectomy reconstruction, indicating multilevel implementation challenges remain.

Key Points

To synthesize multilevel barriers and facilitators to implementing shared decision making (SDM) in postmastectomy breast reconstruction and identify strategies that improve decision quality, patient experience, and equity.
PRISMA 2020-guided mixed-methods systematic review preregistered on OSF, searching six databases (PubMed, Embase, Scopus, Web of Science, Cochrane Library, Trip Database) from inception to November 2025.
Included qualitative, quantitative, and mixed-methods studies (sample sizes ranging from 15 to 485 participants) across North America, Europe, and Asia, synthesizing data via a convergent integrated approach mapped to the Consolidated Framework for Implementation Research.
Interventions such as decision aids, digital tools, and preconsultation education increased patient knowledge by +6% to 32%, decreased decisional conflict by 13 to 25 points, and reduced consultation time by up to 41%.
Key facilitators spanned individual clinician engagement, organizational multidisciplinary collaboration, and macro-level supportive strategies, whereas primary barriers included limited health literacy, workflow constraints, inadequate documentation, and structural inequities.

Cite This Study

Maes‐Carballo et al. (2026) studied this question.

synapsesocial.com/papers/6a8563d703308d306e2d74a7 https://doi.org/10.1177/0272989x261473627

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