Nurses' perceptions of factors influencing patient decision support for place of care at the end of life

Am J Hosp Palliat Care. 2009 Aug-Sep;26(4):254-63. doi: 10.1177/1049909108331316. Epub 2009 Feb 12.

Abstract

Although patients have more choices about where to receive care as death approaches, they often need help with decision making. This study identified factors that influence nurses' provision of decision support. A total of 22 nurses, from 3 health networks, participated in semistructured interviews. Overall, nurses held favorable attitudes toward providing decision support for place of care at end of life. Overlap between other professionals' roles and nurses' clinical experience affected nurses' decision support behaviors. Although nurses considered decision support to be part of patient-centered care, they report a lack of skills, confidence, and tools to help them provide it. These findings confirm the need to develop practical postlicensure education strategies and ways to embed patient decision support tools into systems of care.

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Clinical Competence
  • Decision Support Techniques*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Services Needs and Demand
  • Humans
  • Male
  • Middle Aged
  • Nurse's Role / psychology
  • Nurses / organization & administration
  • Nurses / psychology*
  • Nursing Methodology Research
  • Ontario
  • Palliative Care / organization & administration*
  • Patient Admission*
  • Patient-Centered Care / organization & administration
  • Professional Autonomy
  • Qualitative Research
  • Self Efficacy
  • Surveys and Questionnaires