Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Mar;55(3):922-929.
doi: 10.1016/j.jpainsymman.2017.10.022. Epub 2017 Nov 9.

Shared Decision Making in Home Hospice Nursing Visits: A Qualitative Study

Debra Parker Oliver  1 , Karla Washington  2 , George Demiris  3 , Audrey Wallace  4 , Marc R Propst  5 , Aisha M Uraizee  5 , Kevin Craig  2 , Margaret F Clayton  6 , Maija Reblin  7 , Lee Ellington  6
Affiliations

Shared Decision Making in Home Hospice Nursing Visits: A Qualitative Study

Debra Parker Oliver et al. J Pain Symptom Manage. 2018 Mar.

Abstract

Context: Shared decisions between health care providers and patients and families are replacing the traditional physician-driven plans of care. Hospice philosophy recognizes the patient and family as a unit of care and embraces their role in decision making.

Objective: The goal of this study was to evaluate the shared decisions between hospice nurses and patients and family members.

Methods: A secondary analysis of audio recordings of 65 home hospice nurse visits from 65 home hospice nurse visits in 11 different U.S. hospice programs.

Results: To varying degrees, hospice nurses used all the recommended elements of shared decision making during home visits with patients and families; however, not all elements were used in every visit. The most commonly used element was defining a problem, and the least used element was the assessment of patient and family understanding.

Conclusions: Hospice staff can benefit from a more purposeful shared decision-making process and a greater focus on assessment of patient and family understanding and ability to implement plans of care.

Keywords: Shared decision making; caregiving; family; hospice; nurse visits.

PubMed Disclaimer

References

    1. Makoul G, Clayman M. An integrative model of shared decision making in medical encounters. Patient Educ Couns. 2006;60(3):301–12. - PubMed
    1. Siminoff LA, Step MM. A communication model of shared decision making: Accounting for cancer treatment decisions. Health Psychology. 2005;24(4):S99–S105. - PubMed
    1. Stacey D, Legare F, Pouliot S, Kryworuchko J, Dunn S. Shared decision making models to inform an interprofessional perspective on decision making: A theory analysis. Patient Education & Counseling. 2010;80:164–72. - PubMed
    1. Barr P, Elwyn G. Measurement challenges in shared decision making: Putting the ‘patient’ in patient-reported measures. Health Expectations. 2015. - PMC - PubMed
    1. Presidents Commision for the Study of Ethical Problems in Medicine and Biomedical and Biobehavioral Research Making Health Care Decisions. The Ethical and Legal Implications of Informed Consent in the Patient-Provider Relationship. Washington; 1982.

Publication types