Strategies to facilitate shared decision-making in long-term care.
Lisa A Cranley, Susan E Slaughter, Sienna Caspar and 4 others
PMID 32196984WHAT IT FOUND
Personal support workers, who provide most direct care, were often excluded from decision-making conversations with families.
Residents and families relied heavily on nurses for information. Trust in staff determined how involved families felt they needed to be.
Key findings
01Personal support workers (PSWs) frequently communicated with families only indirectly through nurses or management, rather than directly.
02Family members reported that their level of involvement in care decisions depended on their trust in the care team's quality.
03Residents were generally satisfied with their level of involvement and accepted decisions made by trusted family and staff.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Very small sample size (9 participants) from a single facility limits transferability. No Registered Nurses (RNs) were interviewed, so their perspective is missing. Family participants were those who visited regularly, potentially skewing results toward more engaged families. Resident interviews were short (15-40 mins) and may not have fully captured experiences of those with cognitive impairment.
Declared interests
Not reported in the provided text.
The easy way to misread this
Do not interpret these findings as evidence that specific interventions improve shared decision-making. This is a small descriptive study of perceptions in one home, not a test of a strategy's effectiveness.