TY - JOUR
T1 - Nurses' perspective on their involvement in decision-making about life-prolonging treatments
T2 - A quantitative survey study
AU - Arends, Susanne A. M.
AU - Thodé, Maureen
AU - de Veer, Anke J. E.
AU - Pasman, H. Roeline W.
AU - Francke, Anneke L.
AU - Jongerden, Irene P.
N1 - Funding Information: This work was financially supported by the Netherlands Organization for Health Research and Development (project number 844001513). Funding information Publisher Copyright: © 2022 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.
PY - 2022/9
Y1 - 2022/9
N2 - Aims: In hospital settings, decisions about potentially life-prolonging treatments are often made in a dialogue between a patient and their physician, with a focus on active treatment. Nurses can have a valuable contribution in this process, but it seems they are not always involved. Our aim was to explore how hospital nurses perceive their current role and preferred role in shared decision-making about potentially life-prolonging treatment in patients in the last phase of life. Design: Cross-sectional quantitative study conducted in the Netherlands in April and May 2019. Methods: An online survey, using a questionnaire consisting of 12 statements on nurses' opinion about supporting patients in decisions about potentially life-prolonging treatments, and 13 statements on nurses' actual involvement in these decisions. Results: In total 179 hospital nurses from multiple institutions who care for adult patients in the last phase of life responded. Nurses agreed that they should have a role in shared decision-making about potentially life-prolonging treatments, indicating greatest agreement with ‘It is my task to speak up for my patient’ and ‘It is important that my role in supporting patients is clear’. However, nurses also said that in practice they were often not involved in shared decision-making, with least involvement in ‘active participation in communication about treatment decisions’ and ‘supporting a patient with the decision’. Conclusion: There is a discrepancy between nurses' preferred role in decision-making about potentially life-prolonging treatment and their actual role. More effort is needed to increase nurses' involvement. Impact: Nurses' contribution to decision-making is increasingly considered to be valuable by the nurses themselves, physicians and patients, though involvement is still not common. Future research should focus on strategies, such as training programs, that empower nurses to take an active role in decision-making.
AB - Aims: In hospital settings, decisions about potentially life-prolonging treatments are often made in a dialogue between a patient and their physician, with a focus on active treatment. Nurses can have a valuable contribution in this process, but it seems they are not always involved. Our aim was to explore how hospital nurses perceive their current role and preferred role in shared decision-making about potentially life-prolonging treatment in patients in the last phase of life. Design: Cross-sectional quantitative study conducted in the Netherlands in April and May 2019. Methods: An online survey, using a questionnaire consisting of 12 statements on nurses' opinion about supporting patients in decisions about potentially life-prolonging treatments, and 13 statements on nurses' actual involvement in these decisions. Results: In total 179 hospital nurses from multiple institutions who care for adult patients in the last phase of life responded. Nurses agreed that they should have a role in shared decision-making about potentially life-prolonging treatments, indicating greatest agreement with ‘It is my task to speak up for my patient’ and ‘It is important that my role in supporting patients is clear’. However, nurses also said that in practice they were often not involved in shared decision-making, with least involvement in ‘active participation in communication about treatment decisions’ and ‘supporting a patient with the decision’. Conclusion: There is a discrepancy between nurses' preferred role in decision-making about potentially life-prolonging treatment and their actual role. More effort is needed to increase nurses' involvement. Impact: Nurses' contribution to decision-making is increasingly considered to be valuable by the nurses themselves, physicians and patients, though involvement is still not common. Future research should focus on strategies, such as training programs, that empower nurses to take an active role in decision-making.
KW - decision-making
KW - life-prolonging treatment
KW - nurses
KW - nursing
KW - palliative care nursing
KW - survey
UR - http://www.scopus.com/inward/record.url?scp=85126789015&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/jan.15223
DO - https://doi.org/10.1111/jan.15223
M3 - Article
C2 - 35307867
SN - 0309-2402
VL - 78
SP - 2884
EP - 2893
JO - Journal of Advanced Nursing
JF - Journal of Advanced Nursing
IS - 9
ER -