ONA: How can oncology nurses identify which patients may be reluctant to participate in shared decision making?

GOLDBACH: Nurses are most often the health care professional charged with identifying and engaging patients who may benefit from SDM, providing patients with decision aids, and coaching them through their decision. Identification and engagement are critical steps for any effective program. 

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For example, Health Dialog’s RN Health Coaches are trained in motivational interviewing and take a whole person approach to understanding patients’ needs and barriers to care. They also receive specific training in SDM, and then further training on how to engage even those people who may be initially hesitant about the program.

Some patients experience decisional conflict or feeling stuck about a health care decision and struggle to participate. Health Dialog nurses are exceptional at identifying patients’ barriers to participating in the program and then helping them find ways to overcome those barriers.

ONA: What can nurses do to encourage patients’ participation in their health care decisions?

GOLDBACH: Nurses can encourage adopting SDM programs that manage shared decision making in such a way as to ensure that it is available to all who need it. An effective program identifies the applicable patients, has a system for engaging them, measures the effectiveness of engagement, and features highly trained nurses to transfer knowledge and provide decision support.

The program needs to be available to the patient in a way that’s convenient for patients, so after-hours options are important. Nurses can help increase patients’ confidence levels by providing decision aids that show real people who have gone through the same decision process.

Nurses can help patients strategize their meetings with physicians to facilitate a more effective interaction. Achieving real results can be difficult without a true population-based program. Just presenting available content does not accomplish much; nurses need to establish a relationship with their patients in the course of providing care. Oncology nurses are known to rely on this strategy.