Nurses' Perceptions of Their Involvement in Shared Decision‐Making for Advanced Cancer Treatment and Palliative Care; a Qualitative Interview Study

ABSTRACT

Aim

To explore nurses' perceptions of their involvement in shared decision-making for advanced cancer treatment and palliative care, and their contributions to patient involvement.

Design

Exploratory qualitative research.

Methods

In-depth interviews conducted in March–October 2023 with 15 nurses from two Norwegian hospitals were analysed using reflexive thematic analysis.

Results

Two broad themes were constructed: Theme (1) ‘Person-centredness; acquiring and sharing knowledge’; with subthemes; ‘Knowing and speaking for the person with cancer’, and ‘Providing informational, emotional and practical facilitation and support’, and Theme (2) Enacting the professional nurse role in complex situations'; with subthemes: ‘Palliative cancer care decision-making is particularly complex’, ‘Systems and cultures shape nurses’ roles and contributions', and ‘Balancing beneficence and patient autonomy’.

Conclusion

Participants perceived themselves as contributing to shared decision-making, while facing challenges and dilemmas in their professional roles. More supportive interprofessional working might improve how health professionals involve patients in shared decision-making.

Implications for the Profession and Patient Care

Increased development of nurses' contributions to shared decision-making about advanced cancer and palliative care could support their facilitation of patient involvement.

Impact

Although nurses can support people receiving palliative cancer treatment and care in shared decision-making, nursing's particular role and contribution has been unclear. Study findings suggest that nurses' important person-centred approach is challenging to maintain in treatment decision-making. These insights into nurses' involvement in shared decision-making could inform and contribute to the further development of interprofessional education, training, and leadership.

Reporting Method

COREQ.

What Does This Paper Contribute to the Wider Global Clinical Community?

Provides in-depth knowledge on nurses' perceptions of their contributions to shared decision-making with patients and caregivers. Supports an increasing focus on nurses' role in facilitating and supporting patient involvement in treatment decision-making.

Patient or Public Contribution

A patient and public involvement group participated in study design and conduct.