Paula Brogan1, Felicity Hasson2, Sonja McIlfatrick3. 1. 1 School of Communication, Ulster University, Newtownabbey, Northern Ireland. 2. 2 Institute of Nursing and Health Research, School of Nursing, Ulster University, Newtownabbey, Northern Ireland. 3. 3 School of Nursing, Ulster University, Newtownabbey, Northern Ireland.
Abstract
BACKGROUND: Globally recommended in healthcare policy, Shared Decision-Making is also central to international policy promoting community palliative care. Yet realities of implementation by multi-disciplinary healthcare professionals who provide end-of-life care in the home are unclear. AIM: To explore multi-disciplinary healthcare professionals' perceptions and experiences of Shared Decision-Making at end of life in the home. DESIGN: Qualitative design using focus groups, transcribed verbatim and analysed thematically. SETTING/PARTICIPANTS: A total of 43 participants, from multi-disciplinary community-based services in one region of the United Kingdom, were recruited. RESULTS: While the rhetoric of Shared Decision-Making was recognised, its implementation was impacted by several interconnecting factors, including (1) conceptual confusion regarding Shared Decision-Making, (2) uncertainty in the process and (3) organisational factors which impeded Shared Decision-Making. CONCLUSION: Multiple interacting factors influence implementation of Shared Decision-Making by professionals working in complex community settings at the end of life. Moving from rhetoric to reality requires future work exploring the realities of Shared Decision-Making practice at individual, process and systems levels.
BACKGROUND: Globally recommended in healthcare policy, Shared Decision-Making is also central to international policy promoting community palliative care. Yet realities of implementation by multi-disciplinary healthcare professionals who provide end-of-life care in the home are unclear. AIM: To explore multi-disciplinary healthcare professionals' perceptions and experiences of Shared Decision-Making at end of life in the home. DESIGN: Qualitative design using focus groups, transcribed verbatim and analysed thematically. SETTING/PARTICIPANTS: A total of 43 participants, from multi-disciplinary community-based services in one region of the United Kingdom, were recruited. RESULTS: While the rhetoric of Shared Decision-Making was recognised, its implementation was impacted by several interconnecting factors, including (1) conceptual confusion regarding Shared Decision-Making, (2) uncertainty in the process and (3) organisational factors which impeded Shared Decision-Making. CONCLUSION: Multiple interacting factors influence implementation of Shared Decision-Making by professionals working in complex community settings at the end of life. Moving from rhetoric to reality requires future work exploring the realities of Shared Decision-Making practice at individual, process and systems levels.
Entities:
Keywords:
Shared decision-making; community; decision-making; end-of-life care; focus group; home care; multi-disciplinary; palliative care
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