Shared decision-making in home-care from the nurse's perspective: sitting at the kitchen table - a qualitative descriptive study

2013 ◽  
Vol 22 (19-20) ◽  
pp. 2883-2895 ◽  
Author(s):  
Marie Truglio-Londrigan
Keyword(s):  
Decision Making ◽  
Home Care ◽  
Shared Decision Making ◽  
Descriptive Study ◽  
Shared Decision ◽  
Kitchen Table ◽  
Qualitative Descriptive

scholarly journals Person-centered dementia care in home care services – highly recommended but still challenging to obtain: a qualitative interview study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kari-Anne Hoel ◽  
Anne Marie Mork Rokstad ◽  
Ingvild Hjorth Feiring ◽  
Bjørn Lichtwarck ◽  
Geir Selbæk ◽  
...  
Keyword(s):  
Decision Making ◽  
Home Care ◽  
Shared Decision Making ◽  
Care Service ◽  
Home Care Services ◽  
Shared Decision ◽  
Care Services ◽  
Person Centered Care ◽  
People With Dementia ◽  
Centered Care

Abstract Background Dementia is one of the main causes of disability and dependence in older people, and people with dementia need comprehensive healthcare services, preferably in their own homes. A well-organized home care service designed for people with dementia is necessary to meet their needs for health- and social care. Therefore, it is important to gain knowledge about how people with dementia experience the home care service and if the service responds to their wishes and needs. The aim of this study was to explore the experience of home care services among people with dementia, to understand the continuity in services, how the service was adapted to people with dementia, and how the patient experienced person-centered care and shared decision-making. Methods We used a qualitative, exploratory design based on a phenomenological-hermeneutic approach and performed individual in-depth interviews with persons with dementia. A convenience sample of 12 persons with moderate to severe degrees of dementia from four Norwegian municipalities participated in the study. The interviews were conducted in February 2019. Results The findings identified that the participants appreciated the possibility to stay safely in their own homes and mostly experienced good support from staff. They expressed various views and understanding of the service and experienced limited opportunities for user involvement and individualized, tailored service. The overall theme summarizing the findings was: “It is difficult for people with dementia to understand and influence home care services, but the services facilitate the possibility to stay at home and feel safe with support from staff.” Conclusion The participants did not fully understand the organization of the care and support they received from the home care services, but they adapted to the service without asking for changes based on their needs or desires. Although person-centered care is recommended both nationally and internationally, the participants experienced little inclusion in defining the service they received, and it was perceived as unclear how they could participate in shared decision-making.

scholarly journals Healthcare providers' intentions to engage in an interprofessional approach to shared decision-making in home care programs: A mixed methods study

2013 ◽  
Vol 27 (3) ◽  
pp. 214-222 ◽  
Author(s):  
France Légaré ◽  
Dawn Stacey ◽  
Nathalie Brière ◽  
Kimberley Fraser ◽  
Sophie Desroches ◽  
...  
Keyword(s):  
Decision Making ◽  
Mixed Methods ◽  
Home Care ◽  
Shared Decision Making ◽  
Healthcare Providers ◽  
Mixed Methods Study ◽  
Shared Decision

scholarly journals Patients’ and Caregivers’ Conceptualisations of Pressure Ulcers and the Process of Decision-Making in the Context of Home Care

2019 ◽  
Vol 16 (15) ◽  
pp. 2719
Author(s):  
Francisco José García-Sánchez ◽  
Vicente Martínez-Vizcaíno ◽  
Beatriz Rodríguez-Martín
Keyword(s):  
Decision Making ◽  
Home Care ◽  
Shared Decision Making ◽  
Pressure Ulcers ◽  
Comparative Method ◽  
Barriers And Facilitators ◽  
Shared Decision ◽  
Structured Interviews ◽  
Personal Motivation ◽  
Constant Comparative Method

Background: Although the addition of patients in the process of shared decision-making can improve their recovery, there is a lack of knowledge about patients’ and caregivers’ perceptions on the management of pressure ulcers at home. Objectives: To explore the conceptualisations of patients with pressure ulcers and their caregivers on the barriers and facilitators for their involvement in home care and in the process of shared decision-making regarding the care provided. Methods: A qualitative study based on grounded theory in a theoretical sample of 10 patients with pressure ulcers and 15 main caregivers from the health district of Puertollano (Spain). The data were based on semi-structured interviews, analysed using a coding process and the constant comparative method. Results: According to the participants, personal motivation and the involvement of primary care professionals facilitated their participation in the process of shared decision-making and generated feelings of positivity. In contrast, older age, having disabling pathologies, a low educational level or health paternalism were perceived as barriers for their involvement. Conclusions: A non-paternalistic care model and personal motivation facilitate the process of shared decision-making in the care of people with pressure ulcers. Further studies are required to deepen the understanding of this phenomenon and examine the barriers and facilitators for the involvement of patients and caregivers in the management of these injuries in other contexts.

scholarly journals The Experience of Older People in the Shared Decision-Making Process in Advanced Kidney Care

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Nicola Thomas ◽  
Karen Jenkins ◽  
Breeda McManus ◽  
Brian Gracey
Keyword(s):  
Decision Making ◽  
Older People ◽  
Shared Decision Making ◽  
Daily Living ◽  
Research Training ◽  
Research Process ◽  
Shared Decision ◽  
Qualitative Descriptive ◽  
First Time

Introduction. This qualitative descriptive study was designed to understand the experiences of older people (>70 years) when making a decision about renal replacement therapy. This was a coproduced study, whereby patients and carers were involved in all aspects of the research process.Methods. A Patient and Carer Group undertook volunteer and research training. The group developed the interview questions and interviewed 29 people who had commenced dialysis or made a decision not to have dialysis. Interview data were transcribed and analysed, and common themes were identified.Results. 22 men and 7 women (mean age 77.4 yrs) from two hospitals were interviewed. 18 had chosen haemodialysis, 6 peritoneal dialysis, and 5 supportive care. The majority of patients were involved in the dialysis decision. Most were satisfied with the amount of information that they received, although some identified that the quality of the information could be improved, especially how daily living can be affected by dialysis.Conclusion. Our findings show that overall older patients were involved in the dialysis decision along with their families. Our approach is innovative because it is the first time that patients and carers have been involved in a coproduced study about shared decision-making.

scholarly journals A conceptual framework for interprofessional shared decision making in home care: Protocol for a feasibility study

2011 ◽  
Vol 11 (1) ◽  
Author(s):  
France Légaré ◽  
Dawn Stacey ◽  
Nathalie Brière ◽  
Sophie Desroches ◽  
Serge Dumont ◽  
...  
Keyword(s):  
Decision Making ◽  
Home Care ◽  
Conceptual Framework ◽  
Shared Decision Making ◽  
Feasibility Study ◽  
Shared Decision ◽  
Care Protocol

scholarly journals Understanding the patient experience of early unplanned hospital readmission following acute care discharge: a qualitative descriptive study

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e034728
Author(s):  
Julie Considine ◽  
Debra Berry ◽  
Stephanie K Sprogis ◽  
Evan Newnham ◽  
Karen Fox ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Acute Care ◽  
Hospital Readmission ◽  
Clinical Care ◽  
Hospital Readmissions ◽  
Healthcare Team ◽  
Discharge Process ◽  
Shared Decision ◽  
Qualitative Descriptive

ObjectivesTo understand from a patient and carer perspective: (1) what features of the discharge process could be improved to avoid early unplanned hospital readmission (within 72 hours of acute care discharge) and (2) what elements of discharge planning could have enhanced the discharge experience.DesignA qualitative descriptive design was used. Study data were collected using semi-structured interviews that were transcribed verbatim and analysed using inductive thematic analysis. Data related to participant characteristic were collected by medical record audit and summarised using descriptive statistics.SettingThree acute care hospitals from one health service in Australia.ParticipantsPatients who had an early unplanned hospital readmission and/or their carers, if present during the interviews and willing to participate, with patient permission.FindingsThirty interviews were conducted (23 patients only; 6 patient and carer dyads; 1 carer only). Five themes were constructed: ‘experiences of care’, ‘hearing and being heard’, ‘what’s wrong with me’, ‘not just about me’ and ‘all about going home’. There was considerable variability in patients’ and carers’ experiences of hospital care, discharge processes and early unplanned hospital readmission. Features of the discharge process that could be improved to potentially avoid early unplanned hospital readmission were better communication, optimal clinical care including ensuring readiness for discharge and shared decision-making regarding discharge timing and goals on returning home. The discharge experience could have been enhanced by improved communication between patients (and carers) and the healthcare team, not rushing the discharge process and a more coordinated approach to patient transport home from hospital.ConclusionsThe study findings highlight the complexities of the discharge process and the importance of effective communication, shared decision-making and carer engagement in optimising hospital discharge and reducing early unplanned hospital readmissions.

scholarly journals Teaching Shared Decision Making to Family Medicine Residents: A Descriptive Study of a Web-Based Tutorial

2016 ◽  
Vol 2 (2) ◽  
pp. e17 ◽  
Author(s):  
Maxime Dion ◽  
Ndeye Thiab Diouf ◽  
Hubert Robitaille ◽  
Stéphane Turcotte ◽  
Rhéda Adekpedjou ◽  
...  
Keyword(s):  
Decision Making ◽  
Family Medicine ◽  
Shared Decision Making ◽  
Descriptive Study ◽  
Shared Decision ◽  
Web Based ◽  
Family Medicine Residents

scholarly journals Home Care Physical Therapists’ Views on Inter-Professional Shared Decision Making

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1044-1044
Author(s):  
Cindy Moore
Keyword(s):  
Decision Making ◽  
Home Care ◽  
Shared Decision Making ◽  
Physical Therapists ◽  
Structured Interview ◽  
Shared Decision ◽  
Team Members ◽  
Planning Decisions ◽  
Data Collection And Analysis ◽  
Care Outcomes

Abstract Shared decision making (SDM) has been associated with increased patient satisfaction and engagement and improved process and care outcomes. However, SDM use by physical therapists (PTs) working with older adults in the home care setting is not known. Understanding home care PTs’ views about and experiences with SDM, including inter-professional SDM, can inform SDM research and strategies for increasing its use. This presentation highlights inter-professional aspects of SDM described by home care PTs in the qualitative arm of a mixed methods, implementation science frameworks-informed study exploring PTs’ perspectives on SDM in home care. Semi-structured interview data from twenty PTs (80% female; mean age = 50.6, SD=12.7, range 28-73) representing all geographic regions of the continental United States and having varied levels of geriatric (mean 24.2 years, SD=11.6, range 3-40) and home care (mean 15.7, SD=11.5, range 2-40) experience were analyzed using thematic content analysis. A trustworthiness plan guided data collection and analysis, and reflexive journaling, memo, audit trail, peer debriefing, data triangulation, and member checking were used to support study rigor. Three inter-professional SDM-related themes were identified: team members facilitating SDM for all disciplines; within-team sharing of and competition for patient care resources; and limited patient/caregiver participation in team treatment planning decisions. Findings support the need for including inter-professional issues in home care SDM implementation and measurement research and suggest topics to include in future studies.

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