ABSTRACT
OBJECTIVES: This study aimed to develop a scale that can measure the role competency of oncology nurses during shared decision-making process. METHODS: A total of 226 oncology nurses who actively provide direct care to patients from inpatient and outpatient oncology units in the Midwest and Pacific Northwest completed the online or mail survey. Exploratory factor analysis and parallel analysis showed the multidimensionality of the role competency scale on shared decision-making nurses. RESULTS: The role competency scale on shared decision-making nurses revealed four dimensions: knowledge, attitudes, communication, and adaptability. The 22 items have excellent internal consistency with a Cronbach's alpha of 0.91. The four subscales also have adequate reliability with Cronbach's alpha >0.70 as well as greater than 0.70 Spearman-Brown's correlation coefficients in split-half reliability testing for each subscale. CONCLUSION: The new scale has the potential to be used as a clinical tool to assess the need for shared decision-making education and training in oncology nurses.
ABSTRACT
This study aimed to describe the contemporary role of the oncology nurse throughout the entire cancer shared decision-making (SDM) process. Study participants consisted of 30 nurses and nurse practitioners who are actively involved in direct care of patients with cancer in the inpatient or outpatient setting. The major themes that emerged from the content analysis are: oncology nurses have various roles at different time points and settings of cancer SDM processes; patient education, advocacy, and treatment side effects management are among the top nursing roles; oncology nurses value their participation in the cancer SDM process; oncology nurses believe they have a voice, but with various degrees of influence in actual treatment decisions; nurses' level of disease knowledge influences the degree of participation in cancer SDM; and the nursing role during cancer SDM can be complicated and requires flexibility.â©.
Subject(s)
Decision Making , Nurse's Role , Oncology Nursing/standards , Patient Participation , Practice Guidelines as Topic , Professional Role , Adult , Aged , Female , Humans , Male , Middle AgedABSTRACT
This study aimed to identify the barriers and promoters for participation in cancer treatment decision in the era of shared decision-making (SDM) process. A qualitative design was utilized. Nineteen nurses and 11 nurse practitioners from oncology inpatient and outpatient settings participated in semi-structured interviews. Data were analyzed using directed content analysis. The findings include practice barrier, patient barrier, institutional policy barrier, professional barrier, scope of practice barrier, insurance coverage barrier, and administrative barrier. Multidisciplinary team approach, having a nursing voice during SDM, high level of knowledge of the disease and treatment, and personal valuation of SDM participation were perceived as promoters. Oncology nurses and nurse practitioners face many barriers to their participation during SDM. Organizational support and system-wide culture of SDM are essential to achieve better cancer treatment decisions outcome. Additional studies are needed to determine the factors that can promote more participation among nurses and nurse practitioners.
Subject(s)
Decision Making , Oncology Nursing , Patient Care Planning , Adult , Female , Humans , Interviews as Topic , Male , Middle Aged , Neoplasms/therapy , Nurse's Role , Qualitative ResearchABSTRACT
BACKGROUND: Many models of patient-physician relationships have been described since a paternalistic model was postulated in the early 1950s. Among them are the informative model, doctor-as-agent model, shared model of care, family-centered model, and Degner and Beaton's Patterns of Decision Making. OBJECTIVES: This article aims to examine the contemporary role of the nurse during the cancer treatment decision-making process. METHODS: This article reviews the current and evidence-based role of the nurse during cancer treatment decision making, and implications for practice and research are discussed. FINDINGS: Because of external forces, such as rising cost of health care, increasing healthcare consumerism, and increased emphasis on patient-centered care, the shared model of care is taking hold, particularly in the cancer setting. The evolution of these models has caused a shift in the dialogue related to cancer treatment decision making between patients and physicians, as well as oncology nurses. These events contribute to the evolving role of the nurse during the cancer treatment decision-making process.
