Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec, Quebec, Canada.
SE Research Centre, SE Health, Markham, Ontario, Canada.
Nurs Health Sci. 2022 Jun;24(2):487-498. doi: 10.1111/nhs.12946. Epub 2022 May 13.
Interprofessional care teams can play a key role in supporting older adults (and caregivers) in making informed health decisions, yet shared decision making is not widely practiced in home care. Based on an earlier needs assessment with older adults (and caregivers) with home care experience, we aimed to explore the perceptions of home care teams on the decisions facing their clients and their perceived involvement in shared decision making. A cross-sectional study was conducted with 614 home care providers (nurses, personal support workers, rehabilitation professionals) in three Canadian provinces (Quebec, Ontario, and Alberta). Home care providers considered the decision "to stay at home or move" as the most difficult for older adults. Those most frequently involved in decision making with older adults were family members and least involved were physicians. Although all home care providers reported high levels of shared decision-making, we detected an effect of respondent's discipline on self-perceived shared decision-making; nurses and rehabilitation professionals reported significantly higher levels of shared decision making than personal support workers. A more tailored approach is required to support shared decision making in interprofessional care teams.
跨专业护理团队可以在支持老年人（及其照护者）做出明智的健康决策方面发挥关键作用，但在家庭护理中，共同决策并未得到广泛实施。基于对有家庭护理经验的老年人（及其照护者）的早期需求评估，我们旨在探讨家庭护理团队对其客户面临的决策的看法，以及他们对共同决策的感知参与度。在加拿大三个省份（魁北克、安大略和艾伯塔省）进行了一项横断面研究，涉及 614 名家庭护理提供者（护士、个人支持工作者、康复专业人员）。家庭护理提供者认为“留在家里还是搬出去”是老年人最困难的决定。最常参与老年人决策的是家庭成员，而最不参与的是医生。尽管所有家庭护理提供者都报告了高度的共同决策，但我们发现受访者的学科对自我感知的共同决策有影响；护士和康复专业人员报告的共同决策水平明显高于个人支持工作者。需要采取更有针对性的方法来支持跨专业护理团队中的共同决策。
