Nurse Practitioners' Experiences Navigating Treatment Decision-Making Affecting Older People with Neurocognitive...

Area of Science:

• Gerontology
• Oncology Nursing
• Neuroscience

Background:

• Older adults with neurocognitive disorders (NCDs) and cancer face care access barriers and higher mortality.
• Nurse practitioners (NPs) are crucial in treatment decisions for this population but are underrepresented in research.
• Limited understanding exists regarding NPs' experiences in managing complex care for NCD patients with cancer.

Purpose of the Study:

• To explore the treatment decision-making experiences of NPs caring for older adults with NCDs and cancer.
• To identify challenges and facilitators in NP decision-making for this vulnerable patient group.
• To inform practice improvements and future research on NP roles in geriatric oncology.

Main Methods:

• Qualitative study using interpretive description methodology.
• Data collected through semi-structured interviews and reflective journaling with NPs.
• Iterative thematic analysis to identify key decision-making themes and implications for practice.

Main Results:

• NP decision-making is influenced by their knowledge, assumptions, and systemic navigation challenges.
• NPs experience ethical complexities and uncertainty but strive for shared decision-making.
• Relational practices are employed by NPs to actively involve older patients and their families.

Conclusions:

• NPs manage intricate treatment decisions for older adults with NCDs and cancer, balancing multiple factors.
• Shared decision-making and relational practices are evident, but require systemic support.
• Enhanced institutional support, education, and community-based research are essential for NPs in this field.