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Exploring shared decision making in HIV nursing care

Executive summary

Background
Shared decision making (SDM) is an important part of promoting self-management and empowerment for patients with long-term health conditions. There has been little empirical research on the nature and practice of SDM in HIV care, in spite of national guidelines promoting the approach.

Research aim
This research project aimed to explore current views and practices amongst UK HIV nurses regarding SDM in order to identify training and support needs.

Methods
This was a mixed-methods study. Part 1 was a qualitative study in which four focus-group discussions (15 participants in total) were held to explore HIV nurses' views and practices around SDM. These were thematically analysed and the results were used to develop Part 2, an online survey that was sent to all members of the National HIV Nurses Association (NHIVNA). The survey sought to identify knowledge, challenges, gaps and training needs in relation to SDM. The survey received 64 responses out of a possible 258, a response rate of 25%.

Results
Qualitative data showed that nurses are supportive of SDM and strive to implement it in everyday practice. Nurses understand SDM as a collaborative process but one that must be negotiated not only with the patient but also with the wider MDT. Nurses face several patient-related, organisational and health-system challenges in implementing SDM. The online survey identifi ed a need for more training on SDM (especially in supporting complex patients) and a need for more resources/decision aids to help facilitate SDM.

Conclusions
SDM is an important aspect of nursing care for people living with HIV. Nurses need more training and resources to implement SDM effectively. In order to develop such training and resources and to better understand the meaning of SDM in HIV care, there is a need for research on patient perspectives and experiences in this area.

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