title: Barriers and Promoters to Participation in the Era of Shared Treatment Decision-Making.
abstract: This study aimed to identify the barriers and promoters for participation in cancer treatment decision in the era of shared decision-making (SDM) process. A qualitative design was utilized. Nineteen nurses and 11 nurse practitioners from oncology inpatient and outpatient settings participated in semi-structured interviews. Data were analyzed using directed content analysis. The findings include practice barrier, patient barrier, institutional policy barrier, professional barrier, scope of practice barrier, insurance coverage barrier, and administrative barrier. Multidisciplinary team approach, having a nursing voice during SDM, high level of knowledge of the disease and treatment, and personal valuation of SDM participation were perceived as promoters. Oncology nurses and nurse practitioners face many barriers to their participation during SDM. Organizational support and system-wide culture of SDM are essential to achieve better cancer treatment decisions outcome. Additional studies are needed to determine the factors that can promote more participation among nurses and nurse practitioners.
authors.affiliation: DePaul University, Chicago, IL, USA.
authors.forename: Sarah P
authors.initials: SP
authors.lastname: McCarter
authors.affiliation: DePaul University, Chicago, IL, USA phdinseattle@yahoo.com.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Tariman
authors.affiliation: DePaul University, Chicago, IL, USA.
authors.forename: Nadia
authors.initials: N
authors.lastname: Spawn
authors.affiliation: DePaul University, Chicago, IL, USA.
authors.forename: Enisa
authors.initials: E
authors.lastname: Mehmeti
authors.affiliation: DePaul University, Chicago, IL, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Bishop-Royse
authors.affiliation: Clinical Trial Educator at Quintiles, Durham, NC, USA.
authors.forename: Ima
authors.initials: I
authors.lastname: Garcia
authors.affiliation: Oncology Specialists S.C., Park Ridge, IL, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Hartle
authors.affiliation: Advocate Medical Group, Chicago, IL, USA.
authors.forename: Katharine
authors.initials: K
authors.lastname: Szubski
mesh_terms: D000328:Adult; D003657:Decision Making; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy; D024802:Nurse's Role; D009859:Oncology Nursing; D010347:Patient Care Planning; D036301:Qualitative Research
keywords: barriers to practice; cancer treatments; multidisciplinary team approach; patient advocacy; patient care planning; promoters to practice; roles of oncology nurses and nurse practitioners; shared decision making