Oncology Nursing and Shared Decision Making for Cancer Treatment

Tariman, Joseph D.; Mehmeti, Enisa; Spawn, Nadia; McCarter, Sarah P.; Bishop‐Royse, Jessica; Garcia, Ima; Hartle, Lisa; Szubski, Katharine

doi:10.1188/16.cjon.560-563

Cited by 45 publications

(34 citation statements)

References 9 publications

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“…In other countries (such as the USA or UK), nurses have been shown to play a more active role in SDM processes in cancer care. 38 The inclusion of third parties (especially nurses) into medical decision-making processes in Germany is an area that requires additional attention in the future. A possible course of action would be to transfer approaches such as nurse coordinators that are used in other countries to the German context.…”

Section: Discussionmentioning

confidence: 99%

How are decisions made in cancer care? A qualitative study using participant observation of current practice

et al. 2017

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ObjectivesShared decision-making has continuously gained importance over the last years. However, few studies have investigated the current state of shared decision-making implementation in routine cancer care. This study aimed to investigate how treatment decisions are made in routine cancer care and to explore barriers and facilitators to shared decision-making using an observational approach (three independent observers). Furthermore, the study aimed to extend the understanding of current decision-making processes beyond the dyadic physician–patient interaction.DesignCross-sectional qualitative study using participant observation with semistructured field notes, which were analysed using qualitative content analysis as described by Hsieh and Shannon.Setting and participantsField notes from participant observations were collected at n=54 outpatient consultations and during two 1-week-long observations at two inpatient wards in different clinics of one comprehensive cancer centre in Germany.ResultsMost of the time, either one physician alone or a group of physicians made the treatment decisions. Patients were seldom actively involved. Patients who were ‘active’ (ie, asked questions, demanded participation, opposed treatment recommendations) facilitated shared decision-making. Time pressure, frequent alternation of responsible physicians and poor coordination of care were the main observed barriers for shared decision-making. We found high variation in decision-making behaviour between different physicians as well as the same physician with different patients.ConclusionMost of the time physicians made the treatment decisions. Shared decision-making was very rarely implemented in current routine cancer care. The entire decision-making process was not observed to follow the principles of shared decision-making. However, some aspects of shared decision-making were occasionally incorporated. Individual as well as organisational factors were found to influence the degree of shared decision-making. If future routine cancer care wishes to follow the principles of shared decision-making, strategies are needed to foster shared decision-making in routine cancer care.

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Section: Discussionmentioning

confidence: 99%

How are decisions made in cancer care? A qualitative study using participant observation of current practice

et al. 2017

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“…Several of the identified pre-conditions for contributing to SDM are recognized in the existing literature as well (Lewis et al, 2016;Tariman et al, 2016;Tariman & Szubski, 2015). When applying an inter-professional approach to SDM where at least two healthcare professionals are involved, the transfer of knowledge and a good relationship and cooperation amongst these healthcare professionals are essential (Tariman et al, 2016). Healthcare professionals should cooperate and determine which health professional is best prepared with knowledge and skills to address the particular needs of patients at different time points (Lewis et al, 2016).…”

Section: Pre-conditions For Contributing To Sdmmentioning

confidence: 99%

“…Yet, attention for the role of nurses in treatment decision‐making has increased (Joseph‐Williams, Elwyn, & Edwards, 2014; Legare et al., 2011; McCarter et al., 2016; Stacey, O’Connor, Graham, & Pomey, 2006; Tariman et al., 2016; Tariman & Szubski, 2015). Among suggested roles for nurses related to decision‐making are educating patients about treatment and side effects, advocating on patients’ behalf and coaching patients in decision‐making (Elwyn et al., 2012, 2017; McCarter et al., 2016; Stacey et al., 2008; Tariman et al., 2016; Tariman & Szubski, 2015). Additionally, nurses may have an important role in end‐of‐life discussions with patients (Buiting et al., 2011).…”

Section: Introductionmentioning

confidence: 99%

The role of hospital nurses in shared decision‐making about life‐prolonging treatment: A qualitative interview study

Hoek

Thodé

Jongerden

et al. 2020

Journal of Advanced Nursing

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Aims To examine hospital nurses’ perception of their actual and potential contribution to shared decision‐making about life‐prolonging treatment and their perception of the pre‐conditions for such a contribution. Design A qualitative interview study. Methods Semi‐structured face‐to‐face interviews were conducted with 18 hospital nurses who were involved in care for patients with life‐threatening illnesses. Data were collected from October 2018‐January 2019. The interviews were recorded, transcribed verbatim and analysed using thematic analysis by two researchers. Results Nurses experienced varying degrees of influence on decision‐making about life‐prolonging treatment. Besides, we identified different points of contact in the treatment trajectory at which nurses could be involved in treatment decision‐making. Nurses’ descriptions of behaviours that potentially contribute to shared decision‐making were classified into three roles as follows: checking the quality of a decision, complementing shared decision‐making and facilitating shared decision‐making. Pre‐conditions for fulfilling the roles identified in this study were: (a) the transfer of information among nurses and between nurses and other healthcare professionals; (b) a culture where there is a positive attitude to nurses' involvement in decision‐making; (c) a good relationship with physicians; (d) knowledge and skills; (e) sufficient time; and (f) a good relationship with patients. Conclusion Nurses described behaviour that reflected a supporting role in shared decision‐making about patients’ life‐prolonging treatment, although not all nurses experienced this involvement as such. Nurses can enhance the shared decision‐making process by checking the decision quality and by complementing and facilitating shared decision‐making. Impact Nurses are increasingly considered instrumental in the shared decision‐making process. To facilitate their contribution, future research should focus on the possible impact of nurses’ involvement in treatment decision‐making and on evidence‐based training to raise awareness and offer guidance for nurses on how to adopt this role.

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“…According to Tariman and Szubski, there is a need for a good evolution of the relationship between patient doctors and nurses in making patient decisions to choose the right treatment. Nurses must have full awareness of their professional role to involve themselves in patient decisions, resolve obstacles faced by patients and use evidence-based interventions to reduce uncertainty in decision-making in patients choosing treatment [25].…”

Section: Discussionmentioning

confidence: 99%

Advanced Stage Cancer Patients Experience in Seeking Treatment in Medan, Indonesia

Deliana¹,

Suza²,

Tarigan³

2019

Open Access Maced J Med Sci

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BACKGROUND: Proper treatment of cancer can make it easier for the healing process. Delay in patients seeking treatment is a problem that often occurs today. Handling of complementary and alternative therapies, which is not appropriate is one of the causes of delay in seeking treatment, which worsens the patient's condition. Patients usually come to health services already diagnosed with advanced cancer. AIM: The purpose of this study is to explore the experience of advanced cancer patients in seeking treatment. METHODS: This study is qualitative research with descriptive phenomenology approach. Participants in this study were 15 advanced cancer patients who were treated in the chemotherapy room at Adam Malik General Hospital Medan and Murni Teguh Hospital using purposive sampling technique. Data collection was done with in-depth interviews. All interviews were first recorded and then transcribed. This study was analysed using the Colaizzi approach method. RESULTS: The six main themes indicated that advanced-stage cancer patients for seeking treatment. Themes such as 1) choose the complementary and alternative treatment rather than medical treatment, 2) seek medical treatment as a final decision, 3) integrating complementary treatment as supportive therapy in addition to medical treatment, 4) external sources influence patient decisions, 5) reduce negative feelings by surrendering to God, and 6) lack of involvement of basic health services. CONCLUSION: Advanced cancer patients have experience using complementary and alternative therapies, which are not appropriate before using a medical treatment on the grounds of distrust of medical treatment and advice from the environment around patients. The importance of nurses in providing appropriate education related to complementary and alternative treatment to cancer patients according to the stage of the disease.

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Oncology Nursing and Shared Decision Making for Cancer Treatment

Cited by 45 publications

References 9 publications

How are decisions made in cancer care? A qualitative study using participant observation of current practice

How are decisions made in cancer care? A qualitative study using participant observation of current practice

The role of hospital nurses in shared decision‐making about life‐prolonging treatment: A qualitative interview study

Advanced Stage Cancer Patients Experience in Seeking Treatment in Medan, Indonesia

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