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.
|Early online date||12 Oct 2017|
|Publication status||Published online - 12 Oct 2017|
- Shared decision-making
- palliative care
- end-of-life care
- home care
- focus group.