Shared Decision-Making in Severe Aortic Stenosis: Experiences and Needs of Older Patients.
Judith J A M van Beek-Peeters, Mirela Habibovic, Miriam C Faes and 6 others
PMID 39937676WHAT IT FOUND
Most older patients wanted collaborative decisions, but only 29.6% reported the highest level of shared decision-making.
Nurses can ask about daily life and include caregivers before discussing treatment options.
Key findings
0155.6% preferred a collaborative decision-making role, but only 29.6% reported the highest level of perceived shared decision-making.
02Higher perceived shared decision-making was associated with higher baseline quality-of-life environment scores, but not with depression and anxiety.
03Professionals discussed identifying a discussion partner with 41.3% of patients and exploring daily life with 52%, less often than treatment goals (75.4%) or options (75.6%).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 127 of 310 eligible patients completed baseline questionnaires, and 80 nonparticipants who allowed clinical data sharing were significantly frailer than participants. Shared decision-making experiences were recalled after treatment or after a decision for conservative treatment, so recall bias may affect the results. Only 4 patients receiving conservative treatment participated, and the focus groups included only men. The study was done at a single Dutch heart center. Study-specific questions lacked psychometric evidence, and the qualitative work did not seek data saturation. Associations were observational and cannot show that shared decision-making caused better quality of life.
Declared interests
Funding was from Amphia Hospital Science Funding (Grant No. 2021-2-05DiMAS-3).
The easy way to misread this
Do not read the association between shared decision-making and quality of life as proof that shared decision-making improves health outcomes. The study was descriptive and observational, and perceived shared decision-making was not associated with depression and anxiety.