title: Patients' experiences of communication and involvement in decision-making about atrial fibrillation treatment in consultations with nurses and physicians.
abstract: BACKGROUND
  Insights in consultations across patient interactions with physicians and nurses are of vital importance for strengthening the patients' involvement in the treatment decision-making process. The experience of involvement and communication in decision-making from the patients' perspective has been sparsely explored.
  
  
  OBJECTIVE
  To examine how patients describe involvement in and communication about decision-making regarding treatment in consultations with nurses and physicians.
  
  
  METHODS
  Twenty-two patients with atrial fibrillation (AF), aged 37-90 years, were interviewed directly after their consultations with nurses and physicians in outpatient AF clinics in six Swedish hospitals.
  
  
  RESULTS
  In consultations with nurses, the patients felt involved when obtaining clarifications about AF as a disease and its treatment and when preparing for and building up confidence in decision-making. In consultations with physicians, the patients felt involved when they could cooperate in decision-making, when acquiring knowledge, and when they felt that they were being understood. One shared category was found in consultations with both nurses and physicians, and the patients felt involved when they had a sense of trust and felt secure during and between consultations.
  
  
  CONCLUSIONS
  Patients with AF stated that they would need to acquire knowledge and build up confidence and ability in order to be effectively involved in the decision-making about treatment. Despite not being actively involved in decision-making, patients felt involved through experiencing supportive and confirming communication.
  
  
  CONCLUSIONS
  Attention must be given to the relationship with the patient to create the conditions for patient involvement in the consultation. This can be achieved through supportive communication attempting to create a feeling of clarity and building confidence. This will support involvement in decision-making concerning AF treatment and feelings of being understood and of trust in physicians and/or nurses.
authors.affiliation: Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden.|Sophiahemmet University, Stockholm, Sweden.
authors.forename: Eleni
authors.initials: E
authors.lastname: Siouta
authors.affiliation: Department of Sociology, Uppsala University, Uppsala, Sweden.
authors.forename: Ulla
authors.initials: U
authors.lastname: Hellström Muhli
authors.affiliation: Jönköping Academy for Quality Improvement and Leadership in Health and Welfare, School of Health Sciences, Jönköping, Sweden.|Ryhov County Hospital, The Region of Jönköping County, Jönköping, Sweden.
authors.forename: Berith
authors.initials: B
authors.lastname: Hedberg
authors.affiliation: Department of Nursing Science, School of Health Sciences, Jönköping University, Jönköping, Sweden.|Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden.|Institute of Nursing, Faculty of Health and Social Science, Bergen University College, Bergen, Norway.
authors.forename: Anders
authors.initials: A
authors.lastname: Broström
authors.affiliation: Sophiahemmet University, Stockholm, Sweden.|Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Bjöörn
authors.initials: B
authors.lastname: Fossum
authors.affiliation: Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden.|Department of Research, Education and Development, Education Center, Södersjukhuset, Stockholm, Sweden.
authors.forename: Klas
authors.initials: K
authors.lastname: Karlgren
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000628:therapy*; D003142:Communication; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D010817:Physician-Patient Relations
keywords: atrial fibrillation; communication; consultation; decision-making; participation; patient involvement