Karla T Washington1, Debra Parker Oliver2, L Ashley Gage3, David L Albright4, George Demiris5. 1. Department of Family and Community Medicine, University of Missouri, Columbia, MO, USA. 2. Department of Family and Community Medicine, University of Missouri, Columbia, MO, USA oliverdr@missouri.edu. 3. Department of Social Work, University of Nebraska at Kearney, Kearney, NE, USA. 4. School of Social Work, The University of Alabama, Tuscaloosa, AL, USA. 5. Department of Biobehavioral Nursing & Health Systems, School of Nursing, University of Washington, Seattle, WA, USA.
Abstract
BACKGROUND: Much of the existing research on shared decision-making in hospice and palliative care focuses on the provider-patient dyad; little is known about shared decision-making that is inclusive of family members of patients with advanced disease. AIM: We sought to describe shared decision-making as it occurred in hospice interdisciplinary team meetings that included family caregivers as participants using video-conferencing technology. DESIGN: We conducted a multimethod study in which we used content and thematic analysis techniques to analyze video-recordings of hospice interdisciplinary team meetings (n = 100), individual interviews of family caregivers (n = 73) and hospice staff members (n = 78), and research field notes. SETTING/PARTICIPANTS: Participants in the original studies from which data for this analysis were drawn were hospice family caregivers and staff members employed by one of five different community-based hospice agencies located in the Midwestern United States. RESULTS: Shared decision-making occurred infrequently in hospice interdisciplinary team meetings that included family caregivers. Barriers to shared decision-making included time constraints, communication skill deficits, unaddressed emotional needs, staff absences, and unclear role expectations. The hospice philosophy of care, current trends in healthcare delivery, the interdisciplinary nature of hospice teams, and the designation of a team leader/facilitator supported shared decision-making. CONCLUSION: The involvement of family caregivers in hospice interdisciplinary team meetings using video-conferencing technology creates a useful platform for shared decision-making; however, steps must be taken to transform family caregivers from meeting attendees to shared decision-makers.
BACKGROUND: Much of the existing research on shared decision-making in hospice and palliative care focuses on the provider-patient dyad; little is known about shared decision-making that is inclusive of family members of patients with advanced disease. AIM: We sought to describe shared decision-making as it occurred in hospice interdisciplinary team meetings that included family caregivers as participants using video-conferencing technology. DESIGN: We conducted a multimethod study in which we used content and thematic analysis techniques to analyze video-recordings of hospice interdisciplinary team meetings (n = 100), individual interviews of family caregivers (n = 73) and hospice staff members (n = 78), and research field notes. SETTING/PARTICIPANTS: Participants in the original studies from which data for this analysis were drawn were hospice family caregivers and staff members employed by one of five different community-based hospice agencies located in the Midwestern United States. RESULTS: Shared decision-making occurred infrequently in hospice interdisciplinary team meetings that included family caregivers. Barriers to shared decision-making included time constraints, communication skill deficits, unaddressed emotional needs, staff absences, and unclear role expectations. The hospice philosophy of care, current trends in healthcare delivery, the interdisciplinary nature of hospice teams, and the designation of a team leader/facilitator supported shared decision-making. CONCLUSION: The involvement of family caregivers in hospice interdisciplinary team meetings using video-conferencing technology creates a useful platform for shared decision-making; however, steps must be taken to transform family caregivers from meeting attendees to shared decision-makers.
Authors: Elaine Wittenberg-Lyles; Debra Parker Oliver; George Demiris; Karla T Washington; Kelly Regehr; Heidi M Wilder Journal: Res Gerontol Nurs Date: 2010-04-20 Impact factor: 1.571
Authors: France Légaré; Dawn Stacey; Susie Gagnon; Sandy Dunn; Pierre Pluye; Dominick Frosch; Jennifer Kryworuchko; Glyn Elwyn; Marie-Pierre Gagnon; Ian D Graham Journal: J Eval Clin Pract Date: 2010-08-03 Impact factor: 2.431
Authors: Karla T Washington; Debra Parker Oliver; Jacquelyn J Benson; Abigail J Rolbiecki; Lucas A Jorgensen; Dulce M Cruz-Oliver; George Demiris Journal: J Psychosoc Oncol Date: 2019-11-06
Authors: Debra Parker Oliver; Karla Washington; George Demiris; Audrey Wallace; Marc R Propst; Aisha M Uraizee; Kevin Craig; Margaret F Clayton; Maija Reblin; Lee Ellington Journal: J Pain Symptom Manage Date: 2017-11-09 Impact factor: 3.612
Authors: Djin Lai; Kristin G Cloyes; Margaret F Clayton; Katherine Doyon; Maija Reblin; Anna C Beck; Lee Ellington Journal: J Hosp Palliat Nurs Date: 2018-02 Impact factor: 1.918
Authors: Debra Parker Oliver; Jessica Tappana; Karla T Washington; Abigail Rolbiecki; Kevin Craig; George Demiris; Collyn Schafer; Mumeenat Winjobi; Margaret F Clayton; Maija Reblin; Lee Ellington Journal: Palliat Support Care Date: 2019-10
Authors: Debra Parker Oliver; Karla T Washington; Kyle Pitzer; Lori Popejoy; Patrick White; Audrey S Wallace; Amy Grimsley; George Demiris Journal: Support Care Cancer Date: 2021-11-25 Impact factor: 3.359
Authors: Debra Parker Oliver; George Demiris; Karla Washington; Robin L Kruse; Greg Petroski Journal: Am J Hosp Palliat Care Date: 2016-07-27 Impact factor: 2.500
Authors: Aline Weis; Sabrina Pohlmann; Regina Poss-Doering; Beate Strauss; Charlotte Ullrich; Helene Hofmann; Dominik Ose; Eva C Winkler; Joachim Szecsenyi; Michel Wensing Journal: BMC Med Inform Decis Mak Date: 2020-07-13 Impact factor: 2.796