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Shared Decision Making in Home Hospice Nursing Visits: A Qualitative Study
Debra Parker Oliver1, Karla Washington1, George Demiris2
1Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, USA.
Journal of Pain and Symptom Management
|November 13, 2017
Summary
Hospice nurses involve patients and families in decision-making, but understanding and implementing care plans need improvement. Enhancing shared decision-making ensures better patient-centered hospice care.
Area of Science:
- Palliative Care
- Nursing Practice
- Health Communication
Background:
- Shared decision-making is increasingly replacing traditional physician-led care plans.
- Hospice care views the patient and family as a unified unit, emphasizing their involvement in decision-making.
Purpose of the Study:
- To evaluate the extent and nature of shared decision-making between hospice nurses and patients/families during home visits.
Main Methods:
- Secondary analysis of 65 audio-recorded home hospice nurse visits.
- Data collected from 11 diverse U.S. hospice programs.
Main Results:
- Hospice nurses utilized various elements of shared decision-making to different degrees.
- Defining the problem was the most frequent element; assessing patient/family understanding was the least frequent.
Conclusions:
- Hospice nurses engage in shared decision-making with patients and families.
- A more deliberate approach to shared decision-making, focusing on assessing patient/family understanding and implementation capacity, is recommended for hospice staff.