Adolescent Shared Decision-Making: A Concept Analysis

Background and Purpose: Adolescent involvement in decision-making processes is influenced by their developmental phase in life, the type of decision, the severity of the adolescent's condition or prognosis, and vulnerability. While developmental science does not support the exclusion of adolescents from decision-making, work to promote adolescent shared decision-making has been hampered by the uncertainty of what the concept means. This paper analyzes the concept of adolescent shared decision-making and brings light to a special population within pediatrics. Methods: Rodgers's evolutionary method was used for this concept analysis. Adolescent shared decision-making was defined along with surrogate and related terms, antecedents, attributes, and consequences. An exemplar was included to further describe the application and context of adolescent shared decision-making. Results: Adolescent shared decision-making is defined as an ongoing process with active participation of multiple parties through shared decision-making to reach an agreed medical decision with a goal to optimize the adolescent's future medical wishes; it may change with time and/or growth and development of the adolescent. Implications for Practice: Adolescent shared decision-making bridges the gap in the continuum of patient-centered, medical care participation. Since nurses often have more contact with patients than providers, the integration of adolescent shared decision-making into practice may help nurses better advocate for adolescents' wishes, especially if they are not able to speak for themselves. Adolescents will feel better prepared for future decision-making in adulthood by empowering them to use their voices to become active contributors within our global society.