NHL Stenden University of Applied Sciences, Leeuwarden, The Netherlands.
General Practice Plus Pharmacy Zoutkamp, Zoutkamp, The Netherlands.
J Clin Nurs. 2024 Jun;33(6):2274-2286. doi: 10.1111/jocn.17032. Epub 2024 Jan 29.
To explore patients' experiences of shared decision-making, in nursing care during their stay in a healthcare institution.
This study employed a qualitative descriptive design.
Twenty participants were interviewed from two rehabilitation centres, a nephrology ward of a hospital, and a rehabilitation ward of a long-term care facility. A constant comparative method was used for the inductive analysis.
The main theme was 'feeling seen and understood', in the context of person-centred care, which served as the unifying thread across five themes. The five themes included the importance of a positive nurse-patient relationship as a foundation for shared decision-making. Next, patients experienced collaboration, and this was influenced by verbal and non-verbal communication. Another theme was that patients often felt overwhelmed during their stay, affecting shared decision-making. The fourth theme was that many decisions were not made through the shared decision-making process but were still perceived as satisfactory. The final theme highlighted patients' perspectives on their role in decision-making and influencing factors.
Patients describe how feeling seen and understood is a prerequisite for shared decision-making as a part of person-centred care. For nurses, this implies that they should focus on aspects such as building a good relationship and acknowledgement of patients' feelings and circumstances, next to empowering patients to feel knowledgeable and valued. This way patient's motivation to participate in shared decision-making will be enhanced.
Following the EQUATOR guidelines, reporting was guided by the Consolidated Criteria for Reporting Qualitative Research (COREQ).
Patients were involved in the study through interviews during the research process and member checks during analysis.
IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Before initiating shared decision-making processes, prioritise making the patient feel seen and understood. Be mindful that patients often feel overwhelmed during their stay. Use a person-centred approach to make patients feel knowledgeable-this empowers them for shared decision-making.
Research on patients' experiences of shared decision-making in nursing care is limited, yet crucial for understanding patients' needs in shared decision-making. This study highlights patients' perceptions that shared decision-making is best facilitated within the nurse-patient relationship by nurses who primarily focus on ensuring that patients feel acknowledged and understood.
探索患者在医疗机构住院期间的护理中共同决策的体验。
本研究采用定性描述设计。
从两家康复中心、一家医院的肾病病房和一家长期护理机构的康复病房采访了 20 名参与者。采用恒定性比较法进行归纳分析。
主要主题是“被看到和理解的感觉”,在以患者为中心的护理背景下,这是贯穿五个主题的统一主线。五个主题包括积极的护患关系作为共同决策基础的重要性。其次,患者体验到合作,这受到言语和非言语沟通的影响。另一个主题是患者在住院期间经常感到不知所措,这影响了共同决策。第四个主题是,许多决策不是通过共同决策过程做出的,但仍被认为是令人满意的。最后一个主题强调了患者对自己在决策中的角色和影响因素的看法。
患者描述了被看到和理解是共同决策作为以患者为中心的护理一部分的前提条件。对护士而言,这意味着他们应该关注建立良好关系和承认患者的感受和情况等方面,同时赋予患者知识和价值感,从而增强患者参与共同决策的动机。
根据 EQUATOR 指南,本研究报告遵循定性研究综合报告标准(COREQ)。
在研究过程中,患者通过访谈参与了研究,并在分析过程中进行了成员检查。
对专业和/或患者护理的影响:在启动共同决策过程之前,优先让患者感到被看到和理解。注意到患者在住院期间经常感到不知所措。采用以人为本的方法让患者感到有知识-这使他们能够参与共同决策。
关于患者在护理中共同决策体验的研究有限,但对于了解患者在共同决策中的需求至关重要。本研究强调了患者的看法,即护士主要关注确保患者感到被承认和理解,最有利于在护患关系中促进共同决策。