TY - JOUR
T1 - The role of hospital nurses in shared decision-making about life-prolonging treatment: A qualitative interview study
T2 - A qualitative interview study
AU - Bos-van den Hoek, Danique W.
AU - Thodé, Maureen
AU - Jongerden, Irene P.
AU - van Laarhoven, Hanneke W. M.
AU - Smets, Ellen M. A.
AU - Tange, Dorien
AU - Henselmans, Inge
AU - Pasman, H. Roeline
N1 - Chinese title: 医院护士在延长生命治疗共同决策中的作用:定性访谈研究 Funding Information: This work was financially supported by the Netherlands Organization for Health Research and Development (ZonMw, #844001514 and #844001513). Publisher Copyright: © 2020 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd
PY - 2021/1
Y1 - 2021/1
N2 - Aims: To examine hospital nurses’ perception of their actual and potential contribution to shared decision-making about life-prolonging treatment and their perception of the pre-conditions for such a contribution. Design: A qualitative interview study. Methods: Semi-structured face-to-face interviews were conducted with 18 hospital nurses who were involved in care for patients with life-threatening illnesses. Data were collected from October 2018-January 2019. The interviews were recorded, transcribed verbatim and analysed using thematic analysis by two researchers. Results: Nurses experienced varying degrees of influence on decision-making about life-prolonging treatment. Besides, we identified different points of contact in the treatment trajectory at which nurses could be involved in treatment decision-making. Nurses’ descriptions of behaviours that potentially contribute to shared decision-making were classified into three roles as follows: checking the quality of a decision, complementing shared decision-making and facilitating shared decision-making. Pre-conditions for fulfilling the roles identified in this study were: (a) the transfer of information among nurses and between nurses and other healthcare professionals; (b) a culture where there is a positive attitude to nurses' involvement in decision-making; (c) a good relationship with physicians; (d) knowledge and skills; (e) sufficient time; and (f) a good relationship with patients. Conclusion: Nurses described behaviour that reflected a supporting role in shared decision-making about patients’ life-prolonging treatment, although not all nurses experienced this involvement as such. Nurses can enhance the shared decision-making process by checking the decision quality and by complementing and facilitating shared decision-making. Impact: Nurses are increasingly considered instrumental in the shared decision-making process. To facilitate their contribution, future research should focus on the possible impact of nurses’ involvement in treatment decision-making and on evidence-based training to raise awareness and offer guidance for nurses on how to adopt this role.
AB - Aims: To examine hospital nurses’ perception of their actual and potential contribution to shared decision-making about life-prolonging treatment and their perception of the pre-conditions for such a contribution. Design: A qualitative interview study. Methods: Semi-structured face-to-face interviews were conducted with 18 hospital nurses who were involved in care for patients with life-threatening illnesses. Data were collected from October 2018-January 2019. The interviews were recorded, transcribed verbatim and analysed using thematic analysis by two researchers. Results: Nurses experienced varying degrees of influence on decision-making about life-prolonging treatment. Besides, we identified different points of contact in the treatment trajectory at which nurses could be involved in treatment decision-making. Nurses’ descriptions of behaviours that potentially contribute to shared decision-making were classified into three roles as follows: checking the quality of a decision, complementing shared decision-making and facilitating shared decision-making. Pre-conditions for fulfilling the roles identified in this study were: (a) the transfer of information among nurses and between nurses and other healthcare professionals; (b) a culture where there is a positive attitude to nurses' involvement in decision-making; (c) a good relationship with physicians; (d) knowledge and skills; (e) sufficient time; and (f) a good relationship with patients. Conclusion: Nurses described behaviour that reflected a supporting role in shared decision-making about patients’ life-prolonging treatment, although not all nurses experienced this involvement as such. Nurses can enhance the shared decision-making process by checking the decision quality and by complementing and facilitating shared decision-making. Impact: Nurses are increasingly considered instrumental in the shared decision-making process. To facilitate their contribution, future research should focus on the possible impact of nurses’ involvement in treatment decision-making and on evidence-based training to raise awareness and offer guidance for nurses on how to adopt this role.
KW - decision-making
KW - hospice and palliative care nursing
KW - nurses
KW - nurse–patient relations
KW - nursing
KW - palliative care
KW - qualitative interview study
KW - shared decision-making
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U2 - https://doi.org/10.1111/jan.14549
DO - https://doi.org/10.1111/jan.14549
M3 - Article
C2 - 33078865
SN - 0309-2402
VL - 77
SP - 296
EP - 307
JO - Journal of advanced nursing
JF - Journal of advanced nursing
IS - 1
ER -