Rabben, Jannicke; Fossum, Mariann; Vivat, Bella; Rohde, Gudrun Elin; (2025) Nurses' Perceptions of Their Involvement in Shared Decision-Making for Advanced Cancer Treatment and Palliative Care; a Qualitative Interview Study. Journal of Advanced Nursing 10.1111/jan.16994. (In press).

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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.

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