- •Health status, medication-related knowledge, the therapeutic nurse-patient relationship, time pressure and workload can hinder the application of medication-related shared decision making between nurses and patients.
- •Patients perceived nurses as key persons in the process of shared decision making regarding medication.
- •Individual and contextual factors determined patients' desire for involvement in medication-related decisions.
(i) To explore patients' and nurses’ experiences with medication-related shared decision making (SDM) (i.e., familiarity with the concept, application of medication-related SDM, barriers and facilitators towards its application) and (ii) to explore their role perceptions, respectively.
A qualitative study was conducted in which seven interviews with oncological patients and a focus group interview with six nurses were performed. Prior to the interviews, observations of the application of shared decision making were conducted using the OPTION-12 scale. The observations were used exclusively to trigger the group discussion. Data were collected from November 2020 until March 2021.
According to participants, the application of SDM regarding medication by nurses in oncology is limited. Barriers mentioned are health status, medication-related knowledge, the therapeutic nurse-patient relationship, time pressure and workload. Patients valued nurses' contribution to SDM regarding medication and perceived them as key persons because of their advocating, informative, facilitating and supportive role. Individual and contextual factors determined patients’ desire for involvement in medication-related decisions.
Participants solely concentrated on SDM concerning drug choice and management of therapeutic and adverse effects. The patients' and nurses’ experiences and perceptions towards SDM in other domains of pharmaceutical care need further investigation.
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- Shared decision-making measures: a systematic review.Qual. Manag. Health Care. 2020; 29: 54-66https://doi.org/10.1097/qmh.0000000000000250
- Person-Centered care: a definition and essential elements.J. Am. Geriatr. Soc. 2016; 64: 15-18https://doi.org/10.1111/jgs.13866
- Challenges in achieving patient participation: a review of how patient participation is addressed in empirical studies.Int. J. Nurs. Stud. 2015; 52: 1525-1538https://doi.org/10.1016/j.ijnurstu.2015.04.008
- Patient preference and the impact of decision-making aids on prostate cancer treatment choices and post-intervention regret.Curr. Oncol. 2012; 19: S37-44https://doi.org/10.3747/co.19.1287
- Shared decision making--pinnacle of patient-centered care.N. Engl. J. Med. 2012; 366: 780-781https://doi.org/10.1056/NEJMp1109283
- Everything is perfect, and we have No problems": detecting and limiting social desirability bias in qualitative research.Qual. Health Res. 2020; 30: 783-792https://doi.org/10.1177/1049732319889354
- The role of hospital nurses in shared decision-making about life-prolonging treatment: a qualitative interview study.J. Adv. Nurs. 2021; 77: 296-307https://doi.org/10.1111/jan.14549
- Using thematic analysis in psychology.Qual. Res. Psychol. 2006; 3: 77-101https://doi.org/10.1191/1478088706qp063oa
- Patients' preferences for participation in treatment decision-making at the end of life: qualitative interviews with advanced cancer patients.PLoS One. 2014; 9e100435https://doi.org/10.1371/journal.pone.0100435
- Perceptions of physicians, medical and nursing students concerning shared decision-making: a cross-sectional study.Acta Clin. Belg. 2021; 76: 1-9https://doi.org/10.1080/17843286.2019.1637487
- Patient preferences for shared decisions: a systematic review.Patient Educ. Counsel. 2012; 86: 9-18https://doi.org/10.1016/j.pec.2011.02.004
- Paternalism in nursing and healthcare: central issues and their relation to theory.Nurs. Sci. Q. 2003; 16: 288-296https://doi.org/10.1016/j.ijnurstu.2015.04.008
- Assessments of the extent to which health-care providers involve patients in decision making: a systematic review of studies using the OPTION instrument.Health Expect. 2015; 18: 542-561https://doi.org/10.1111/hex.12054
- Paternalism or partnership?.BMJ. 1999; 319: 719https://doi.org/10.1136/bmj.319.7212.719
- Nurses' responsibilities and tasks in pharmaceutical care: a scoping review.Nurs Open. 2021; https://doi.org/10.1002/nop2.984
- The NUPHAC-EU framework for nurses' role in interprofessional pharmaceutical care: cross-sectional evaluation in Europe.Int. J. Environ. Res. Publ. Health. 2021; 18: 7862https://doi.org/10.3390/ijerph18157862
- Shared Decision Making - Measurement Using the OPTION Instrument.Centre for Health Sciences Research, Cardiff University, Wales2005
- Shared decision making: developing the OPTION scale for measuring patient involvement.Qual. Saf. Health Care. 2003; 12: 93-99https://doi.org/10.1136/qhc.12.2.93
- The OPTION scale: measuring the extent that clinicians involve patients in decision-making tasks.Health Expect. 2005; 8: 34-42https://doi.org/10.1111/j.1369-7625.2004.00311.x
- Implementing shared decision making in the NHS.BMJ. 2010; 341: c5146https://doi.org/10.1136/bmj.c5146
- The desire for shared decision making among patients with solid and hematological cancer.Psycho Oncol. 2011; 20: 186-193https://doi.org/10.1002/pon.1723
- Shared decision making in chronic care in the context of evidence based practice in nursing.Int. J. Nurs. Stud. 2015; 52: 393-402https://doi.org/10.1016/j.ijnurstu.2014.06.012
- Do patients benefit from participating in medical decision making? Longitudinal follow-up of women with breast cancer.Psycho Oncol. 2006; 15: 9-19https://doi.org/10.1002/pon.907
- From the sidelines: coaching as a nurse practitioner strategy for improving health outcomes.J. Am. Acad. Nurse Pract. 2007; 19: 555-562https://doi.org/10.1111/j.1745-7599.2007.00264.x
- Crossing the Quality Chasm: A New Health System for the 21st Century.The National Academies Press, Washington DC2001
- Systematic review of the effects of shared decision-making on patient satisfaction, treatment adherence and health status.Psychother. Psychosom. 2008; 77: 219-226https://doi.org/10.1159/000126073
- Cancer patients' perspective on shared decision-making and decision aids in oncology.J. Cancer Res. Clin. Oncol. 2021; 147: 1725-1732https://doi.org/10.1007/s00432-021-03579-6
- Implementing and evaluating shared decision making in oncology practice.CA A Cancer J. Clin. 2014; 64: 377-388https://doi.org/10.3322/caac.21245
- Shared decision making for treatment of cancer: challenges and opportunities.J. Oncol. Pract. 2014; 10: 206-208https://doi.org/10.1200/JOP.2014.001434
- What makes a patient ready for Shared Decision Making? A qualitative study.Patient Educ. Counsel. 2021; 104: 571-577https://doi.org/10.1016/j.pec.2020.08.031
- The shared decision-making continuum.JAMA. 2010; 304: 903-904https://doi.org/10.1001/jama.2010.1208
- A vision for patient-centered health information systems.JAMA. 2011; 305: 300-301https://doi.org/10.1001/jama.2010.2011
- Patient participation in shared decision-making in palliative care – an integrative review.J. Clin. Nurs. 2021; 30: 3415-3428https://doi.org/10.1111/jocn.15866
- Barriers and facilitators to implementing shared decision-making in clinical practice: update of a systematic review of health professionals' perceptions.Patient Educ. Counsel. 2008; 73: 526-535https://doi.org/10.1016/j.pec.2008.07.018
- Shared decision making: examining key elements and barriers to adoption into routine clinical practice.Health Aff. 2013; 32: 276-284https://doi.org/10.1377/hlthaff.2012.1078
- What makes it so difficult for nurses to coach patients in shared decision making? A process evaluation.Int. J. Nurs. Stud. 2018; 80: 1-11https://doi.org/10.1016/j.ijnurstu.2017.12.005
- An integrative model of shared decision making in medical encounters.Patient Educ. Counsel. 2006; 60: 301-312https://doi.org/10.1016/j.pec.2005.06.010
- The advanced practice clinical nurse specialist.Nurs. Adm. Q. 2017; 41: 70-76https://doi.org/10.1097/naq.0000000000000201
- Barriers and promoters to participation in the Era of shared treatment decision-making.West. J. Nurs. Res. 2016; 38: 1282-1297https://doi.org/10.1177/0193945916650648
- A model of treatment decision making when patients have advanced cancer: how do cancer treatment doctors and nurses contribute to the process?.Eur. J. Cancer Care. 2010; 19: 482-491https://doi.org/10.1111/j.1365-2354.2009.01074.x
- Clinical Guidelines and Evidence Review for Medicines Adherence: Involving Patients in Decisions about Prescribed Medicines and Supporting Adherence.National Collaborating Centre for Primary Care and Royal College of General Practitioners, London2009
- Shared decision making to improve care and reduce costs.N. Engl. J. Med. 2013; 368: 6-8https://doi.org/10.1056/NEJMp1209500
- Barriers and facilitators for shared decision making in older patients with multiple chronic conditions: a systematic review.BMC Geriatr. 2021; 21: 112https://doi.org/10.1186/s12877-021-02050-y
- Physician attitudes toward shared decision making: a systematic review.Patient Educ. Counsel. 2015; 98: 1046-1057https://doi.org/10.1016/j.pec.2015.05.004
- Does lack of deeper understanding of shared decision making explains the suboptimal performance on crucial parts of it? An example from breast cancer care.Eur. J. Oncol. Nurs. 2019; 38: 92-97https://doi.org/10.1016/j.ejon.2018.12.004
- Decision coaching to support shared decision making: a framework, evidence, and implications for nursing practice, education, and policy.Worldviews Evidence-Based Nurs. 2008; 5: 25-35https://doi.org/10.1111/j.1741-6787.2007.00108.x
- Randomized controlled trial of the effectiveness of an intervention to implement evidence-based patient decision support in a nursing call centre.J. Telemed. Telecare. 2006; 12: 410-415https://doi.org/10.1258/135763306779378663
- A patient decision aid for men with localized prostate cancer: a comparative case study of natural implementation approaches.Cancer Nurs. 2020; 43: E10-e21https://doi.org/10.1097/ncc.0000000000000651
- Lessons in integrating shared decision-making into cancer care.J. Oncol. Pract. 2018; 14: 229-235https://doi.org/10.1200/jop.18.00019
- OPTION(5) versus OPTION(12) instruments to appreciate the extent to which healthcare providers involve patients in decision-making.Patient Educ. Counsel. 2016; 99: 1062-1068https://doi.org/10.1016/j.pec.2015.12.019
- Evaluation of decision support tools for patients with advanced cancer: a systematic review of literature.Palliat. Support Care. 2019; 17: 356-364https://doi.org/10.1017/s1478951518000512
- Role competency scale on shared decision-making nurses: development and psychometric properties.SAGE Open Medicine. 2018; 62050312118807614https://doi.org/10.1177/2050312118807614
- Oncology nursing and shared decision making for cancer treatment.Clin. J. Oncol. Nurs. 2016; 20: 560-563https://doi.org/10.1188/16.Cjon.560-563
- The evolving role of the nurse during the cancer treatment decision-making process: a literature review.Clin. J. Oncol. Nurs. 2015; 19: 548-556https://doi.org/10.1188/15.Cjon.548-556
- Decision aids for localized prostate cancer treatment choice: systematic review and meta-analysis.CA Cancer J. Clin. 2015; 65: 239-251https://doi.org/10.3322/caac.21272
- Shared decision making in chronic medication use: scenarios depicting exemplary care.Res. Soc. Adm. Pharm. 2020; 16: 108-110https://doi.org/10.1016/j.sapharm.2019.04.047
- Decision aids that facilitate elements of shared decision making in chronic illnesses: a systematic review.Syst. Rev. 2019; 8: 121https://doi.org/10.1186/s13643-019-1034-4
- World medical association declaration of Helsinki: ethical principles for medical research involving human subjects.JAMA. 2013; 310: 2191-2194https://doi.org/10.1001/jama.2013.281053
Accepted: March 10, 2023
Received in revised form: February 25, 2023
Received: November 29, 2022
Publication stageIn Press Accepted Manuscript
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