Data analysis
Survey responses were summarized using descriptive statistics of
frequency, mean, and central tendency using R statistical software.
A directed, emergent content analysis approach was used to analyze
qualitative interview transcripts. In directed content analysis,
qualitative themes are related to constructs from a theoretical model or
framework; themes that are relevant but fall outside the pre-defined set
of constructs are also identified and
reported.30Two researchers (MRT and SM) developed an initial codebook based on the
interview guide, structured by the adapted SDM framework. Together they
analyzed one patient and one clinician interview transcript each and
discussed the application of codes until consensus was reached, refining
the codebook as needed for clarity. The researchers independently coded
five additional transcripts from four patient interviews and one
clinician interview and participated in an inter-rater reliability test
to ensure high reliability. The remaining transcripts were coded by one
researcher (MRT), and emerging themes were discussed with the other
coding research (SM) during weekly meetings.