Pursuing concordance: moving away from paternalism.

Area of Science:

• Nursing Practice
• Healthcare Ethics
• Shared Decision-Making

Background:

• Concordance in nursing is often perceived as impractical in certain clinical settings.
• Previous work explored concordance in general nursing practice.

Purpose of the Study:

• To argue for the effective pursuit of concordance in challenging clinical settings.
• To explore the application of concordance beyond medicines management in nursing practice.

Main Methods:

• Utilizing Cribb and Entwhistle's concept of shared decision-making.
• Applying the notion of decision-making capacity as a continuum.
• Sourcing legal, ethical, and social participation theories.
• Examining research across healthcare practice.

Main Results:

• Concordance is achievable in challenging areas like childcare, mental health, and elder care.
• Direct and indirect concordance strategies can be employed.
• Concordant approaches are valuable for patients with compromised decision-making capacity.

Conclusions:

• Shared decision-making principles enable concordance in complex nursing scenarios.
• Concordance enhances patient care across all nursing domains, even with fluctuating capacity.
• Ethical and legal frameworks support concordant nursing practice.