Shared decision-making at the end of life: a focus group study exploring the perceptions and experiences of multi-disciplinary healthcare professionals working in the home setting.

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Abstract

Background Globally recommended in healthcare policy, Shared Decision- Making (SDM) is also central to international policy promoting community palliative care. Yet realities of implementation by multi-disciplinary healthcare professionals who provide end of life care in the home are unclear. Aim To explore multi-disciplinary healthcare professionals perceptions and experiences of Shared Decision-Making at end of life in the home.Design Qualitative design using focus groups, transcribed verbatim and analysed thematically.Setting/Participants A total of 43 participants, from multidisciplinary community-based services in one region of the UK were recruited.Results Whilst the rhetoric of Shared Decision-Making was recognised, its implementation was impacted by several interconnecting factors, including 1) conceptual confusion regarding Shared Decision-Making, 2) uncertainty in the process and 3) organisational factors which impeded Shared Decision-Making. Conclusions Multiple interacting factors influence implementation of Shared decision-making by professionals working in complex community settings at the end of life. Moving from rhetoric to reality, requires future work exploring the realities of Shared Decision-Making practice at individual, process and systems levels.
Original languageEnglish
Pages (from-to)1-10
JournalPalliative Medicine
Volumena
Early online date12 Oct 2017
DOIs
Publication statusE-pub ahead of print - 12 Oct 2017

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Keywords

  • Shared decision-making
  • decision-making
  • palliative care
  • end-of-life care
  • home care
  • community
  • multidisciplinary
  • focus group.

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