The perceptions and experiences of community nurses and patients towards shared decision-making in the home setting: An integrative review.
Katie Mills, Lucy McGeagh, Marion Waite and 1 others
PMID 39039800WHAT IT FOUND
Community nurses and patients valued shared decision-making, but observed home nursing practice varied widely.
Nurses often focused on assessing problems, while patients wanted to be listened to and trusted before choices were made.
Key findings
01Observed practice varied widely: only two of 22 community nurses consistently involved patients, and 31% of observed nurse visits had no shared decision-making elements.
02Patient preferences and values were heard in 60% of encounters, but risks and benefits were discussed in under a tenth of home visits.
03Trust was central to decision-making, and when patients lacked trust they may not ask questions or describe symptoms fully.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The review had a broad focus on decision-making, so it may miss nuances of specific treatment choices. The included studies were small qualitative studies, so their findings cannot be transferred to all home nursing settings. The 13 studies came from five countries, with nine in Europe and four in the United States, so the picture is not global. Some included studies were about related topics such as self-management or participation, and only part of their findings were relevant. Observational studies could not establish nurses' perceptions of why shared decision-making elements were used or omitted. One included study had a long time lag between data collection and reporting.
Declared interests
The authors reported no specific funding and no conflict of interest.
The easy way to misread this
Do not read this as evidence that shared decision-making improves patient outcomes. This review synthesised perceptions and observations from qualitative studies, not tested interventions or measured effects.