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Shared decision-making in the ICU from the perspective of physicians, nurses and patients: a qualitative interview study
OBJECTIVE: To identify views, experiences and needs for shared decision-making (SDM) in the intensive care unit (ICU) according to ICU physicians, ICU nurses and former ICU patients and their close family members. DESIGN: Qualitative study. SETTING: Two Dutch tertiary centres. PARTICIPANTS: 19 inter...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8359489/ https://www.ncbi.nlm.nih.gov/pubmed/34380728 http://dx.doi.org/10.1136/bmjopen-2021-050134 |
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author | Wubben, Nina van den Boogaard, Mark van der Hoeven, JG Zegers, Marieke |
author_facet | Wubben, Nina van den Boogaard, Mark van der Hoeven, JG Zegers, Marieke |
author_sort | Wubben, Nina |
collection | PubMed |
description | OBJECTIVE: To identify views, experiences and needs for shared decision-making (SDM) in the intensive care unit (ICU) according to ICU physicians, ICU nurses and former ICU patients and their close family members. DESIGN: Qualitative study. SETTING: Two Dutch tertiary centres. PARTICIPANTS: 19 interviews were held with 29 participants: seven with ICU physicians from two tertiary centres, five with ICU nurses from one tertiary centre and nine with former ICU patients, of whom seven brought one or two of their close family members who had been involved in the ICU stay. RESULTS: Three themes, encompassing a total of 16 categories, were identified pertaining to struggles of ICU physicians, needs of former ICU patients and their family members and the preferred role of ICU nurses. The main struggles ICU physicians encountered with SDM include uncertainty about long-term health outcomes, time constraints, feeling pressure because of having final responsibility and a fear of losing control. Former patients and family members mainly expressed aspects they missed, such as not feeling included in ICU treatment decisions and a lack of information about long-term outcomes and recovery. ICU nurses reported mainly opportunities to strengthen their role in incorporating non-medical information in the ICU decision-making process and as liaison between physicians and patients and family. CONCLUSIONS: Interviewed stakeholders reported struggles, needs and an elucidation of their current and preferred role in the SDM process in the ICU. This study signals an essential need for more long-term outcome information, a more informal inclusion of patients and their family members in decision-making processes and a more substantial role for ICU nurses to integrate patients’ values and needs in the decision-making process. |
format | Online Article Text |
id | pubmed-8359489 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-83594892021-08-30 Shared decision-making in the ICU from the perspective of physicians, nurses and patients: a qualitative interview study Wubben, Nina van den Boogaard, Mark van der Hoeven, JG Zegers, Marieke BMJ Open Intensive Care OBJECTIVE: To identify views, experiences and needs for shared decision-making (SDM) in the intensive care unit (ICU) according to ICU physicians, ICU nurses and former ICU patients and their close family members. DESIGN: Qualitative study. SETTING: Two Dutch tertiary centres. PARTICIPANTS: 19 interviews were held with 29 participants: seven with ICU physicians from two tertiary centres, five with ICU nurses from one tertiary centre and nine with former ICU patients, of whom seven brought one or two of their close family members who had been involved in the ICU stay. RESULTS: Three themes, encompassing a total of 16 categories, were identified pertaining to struggles of ICU physicians, needs of former ICU patients and their family members and the preferred role of ICU nurses. The main struggles ICU physicians encountered with SDM include uncertainty about long-term health outcomes, time constraints, feeling pressure because of having final responsibility and a fear of losing control. Former patients and family members mainly expressed aspects they missed, such as not feeling included in ICU treatment decisions and a lack of information about long-term outcomes and recovery. ICU nurses reported mainly opportunities to strengthen their role in incorporating non-medical information in the ICU decision-making process and as liaison between physicians and patients and family. CONCLUSIONS: Interviewed stakeholders reported struggles, needs and an elucidation of their current and preferred role in the SDM process in the ICU. This study signals an essential need for more long-term outcome information, a more informal inclusion of patients and their family members in decision-making processes and a more substantial role for ICU nurses to integrate patients’ values and needs in the decision-making process. BMJ Publishing Group 2021-08-11 /pmc/articles/PMC8359489/ /pubmed/34380728 http://dx.doi.org/10.1136/bmjopen-2021-050134 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Intensive Care Wubben, Nina van den Boogaard, Mark van der Hoeven, JG Zegers, Marieke Shared decision-making in the ICU from the perspective of physicians, nurses and patients: a qualitative interview study |
title | Shared decision-making in the ICU from the perspective of physicians, nurses and patients: a qualitative interview study |
title_full | Shared decision-making in the ICU from the perspective of physicians, nurses and patients: a qualitative interview study |
title_fullStr | Shared decision-making in the ICU from the perspective of physicians, nurses and patients: a qualitative interview study |
title_full_unstemmed | Shared decision-making in the ICU from the perspective of physicians, nurses and patients: a qualitative interview study |
title_short | Shared decision-making in the ICU from the perspective of physicians, nurses and patients: a qualitative interview study |
title_sort | shared decision-making in the icu from the perspective of physicians, nurses and patients: a qualitative interview study |
topic | Intensive Care |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8359489/ https://www.ncbi.nlm.nih.gov/pubmed/34380728 http://dx.doi.org/10.1136/bmjopen-2021-050134 |
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