Barthow Christine, Moss Cheryle, McKinlay Eileen, McCullough Leslie, Wise Debbie
Graduate School of Nursing, Midwifery and Health, Victoria University of Wellington, Wellington, New Zealand.
Eur J Oncol Nurs. 2009 Feb;13(1):22-8. doi: 10.1016/j.ejon.2008.09.004. Epub 2008 Nov 17.
Decisional support is a multifaceted process of facilitating patients' decision making regarding treatment choices. Effective decisional support practices of nurses in relation to the use of anticancer therapies in patients with advanced disease are central to quality cancer care. A recent qualitative descriptive study (n=21) exploring the decision making practices of doctors and nurses in one tertiary cancer centre in New Zealand identified many complexities associated with nurses and their participation in decisional support. The study revealed that cancer nurses had varied opinions about the meaning and importance of their roles in treatment related decision making. This variation was significant and led the researchers to undertake a detailed secondary exploration of factors that impacted on the nurses' involvement in the provision of decisional support. Four key groups of factors were identified. These were factors relating to degree of knowledge, level of experience, beliefs and understandings about nursing roles and cancer therapies, and structural interfaces in the work setting. Understanding these factors is important because it allows modification of the conditions which impact on the ability to provide effective decisional care. It also provides some understanding of clinical drivers associated with nurses' decisional support work with patients who have advanced cancer.
决策支持是一个多方面的过程，旨在促进患者在治疗选择方面的决策。护士在晚期疾病患者使用抗癌疗法方面的有效决策支持实践对于优质癌症护理至关重要。最近一项定性描述性研究（n = 21）探讨了新西兰一家三级癌症中心医生和护士的决策实践，发现了许多与护士及其参与决策支持相关的复杂性。该研究表明，癌症护士对其在治疗相关决策中的角色的意义和重要性有不同的看法。这种差异很显著，促使研究人员对影响护士参与提供决策支持的因素进行详细的二次探索。确定了四组关键因素。这些因素与知识程度、经验水平、对护理角色和癌症疗法的信念及理解，以及工作环境中的结构接口有关。理解这些因素很重要，因为它允许改变影响提供有效决策护理能力的条件。它还提供了一些对与护士为晚期癌症患者提供决策支持工作相关的临床驱动因素的理解。
