Nurse-led shared decision making with patients: A scoping review

Shared decision making has gained increasing attention as part of person-centred care. However, research on shared decision making has largely focused on physician-patient interactions, and little is known about nurse-led shared decision making between nurses and patients.

To identify and synthesise empirical evidence on nurse-led shared decision making with patients or families, examining: 1) contexts and decision types, 2) intervention components, 3) reported outcomes and experiences, and 4) guiding frameworks.

A scoping review was conducted following Arksey and O'Malley. MEDLINE, CINAHL, and Scopus were searched, supplemented by citation tracking to March 2026. Included citations were empirical studies describing shared decision making occurring directly between a nurse and a patient or family member. Screening and data extraction were conducted independently by two researchers. Findings were synthesised descriptively and as part of the final stage of the review, findings were reviewed and verified through consultation with experts.

Of 19,215 citations identified, 23 publications of 22 studies were eligible. Nurse-led shared decision making occurred in the clinical contexts of nephrology, oncology, primary care, psychiatry, rehabilitation, neonatal, home care, and hospice. The types of decision included major treatment decisions and everyday nursing care decisions. Interventions were shared decision making training, structured consultations (e.g. specific stages or steps of interactions), and decision support (e.g., patient decision aids, decision coaching), and some studies additionally included implementation supports. Nurse-led shared decision making increased patient involvement in decision making, perceived empowerment, satisfaction with shared decision making and treatment, self-confidence in decision making, and adherence to treatment. Common barriers to nurse-led shared decision making included time constraints and lack of organisational support. Of 15 studies citing shared decision making frameworks, one was nursing-specific: King's Goal Attainment Theory and one was interprofessional: Interprofessional Shared Decision-Making Model.

The limited evidence on nurse-led shared decision making spans diverse clinical contexts and uses various interventions. Future research of nurse-led shared decision making interventions should improve the consistency and reporting of intervention components, and examine how these interventions can be implemented in clinical nursing practice.