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Shared decision-making in home-care from the nurse's perspective: sitting at the kitchen table--a qualitative
1The College of Health Professions, Lienhard School of Nursing, Pace University, Pleasantville, NY, USA.
Aims And Objectives:
To come to know, understand and describe the experience of shared decision-making in home-care from the nurse's perspective.
Background:
The literature presents the concept of shared decision-making as a complex process characterised by a partnership between the healthcare provider and the patient, which is participatory and action oriented with education and negotiation leading to agreement. Few studies have been carried out to explore and describe the events that make up the experiences of shared decision-making in home-care from the nurse's perspective.
Design:
A qualitative descriptive study was implemented.
Method:
Semi structured interviews were performed with 10 home-care nurses who were asked to reflect on a time in their practice when they were involved in a shared decision-making process with their patient. All data were analysed using Colaizzi's method.
Findings:
The following Themes were uncovered: Begin where the patient is; Education for shared decision-making; The village and shared decision-making; and Whose decision is it? Each of the four Themes contained Subthemes.
Conclusions:
The findings of this study present shared decision-making as a complex, multidimensional and fluid process. A thorough understanding of shared decision-making is essential within the multiple contexts in which care is delivered.
Relevance To Clinical Practice:
Nurses in clinical practice need to know and understand the events of the experience of shared decision-making. A more comprehensive understanding of these facts can assist home-care nurses in their practice with regard to the application of shared decision-making.
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