Exploring SDM in HIV nursing care
SDM(Q.9).TheneedformoreresourcesisalsoreflectedinQ.8whereonly12.5%saidthey`always
used'decisionaidswithpatients.
Limitations of the research
TheresearchexploredSDMfromtheperspectiveoftheHIVnurseanddidnottakeintoconsideration
theviewsandperspectivesofpatients,orthoseofotherhealthprofessionalsinvolvedinHIVcare.
Assuch,theinterpretationsofferedherearelimitedtooneprofessionalperspective.
Recommendations
Theissuesraisedbythisreportcanbeaddressedinthreeways:
1.
Education/trainingforprofessionals.Thereisaclearneedforadditionaltrainingtobe
providedforHIVnursesaroundSDM,withaspecificfocusonsupportingchallengingpatient
situations. The questionnaire (Q.17) indicated that 78% of respondents wanted greater
knowledgeaboutSDMand56%wantedthistrainingtobe`practical,includingroleplaying'.
Themajorityofrespondentswantedtrainingtobedeliveredase-learningorstudydays.
2.
Developmentofdecisionsupportresources.Thereisaneedtodevelopdecisionsupport
aids that nurses can use with their patients on a range of topics. This study has clearly
identifiedagapinavailabilityofresourcestosupportSDM.
3.
Furtherresearch.Inordertoinformthecontentoftrainingorresources,itisimportantto
understandthepatientperspectiveforSDM.Thereiscurrentlyalackofresearchonpatient
experiencesofSDMinUKHIVcare.Suchresearchisrequired.Similarly,undertakingresearch
on the views of other health professionals around SDM would help to provide a more
comprehensivepictureofcurrentissuesandchallenges.
Conclusions
ThisstudyhasdemonstratedHIVnurses'commitmenttoSDM.Ithashighlightedhithertounder-
recognisedelementsofthenurse'sroleinSDMintermsoffacilitatingtheprocesswithinawider
MDT.Thestudyhasalsohighlightedseveralpatient-related,organisationalandstructuralchal enges
toSDM.Final y,thestudyhasidentifiedaneedforgreatertrainingfornursesaroundSDMand
forthedevelopmentofdecision-supportresources.AsthetreatmentofHIVinfectionprogresses
towardsachronicdisease-managementmodel,developingskil sinSDMisessentialinorderto
facilitatebetterlong-termhealthoutcomes.
Acknowledgements
TheteamthanksGileadSciencesLtdforprovidingfundingforthisproject.Wearegratefulto
NatasherLafondforhelpingwiththeresearchprocess.Final y,wethankal theparticipantsfor
kindlygivinguptheirtimetosharetheirviewsandexperiencesonshareddecisionmaking.
Abbreviations
ART
Antiretroviraltherapy
ARV
Antiretroviral
FGD
Focus-groupdiscussion
HIV
Humanimmunodeficiencyvirus
2016
MDT
Multidisciplinaryteam
NHIVNA
NationalHIVNursesAssociation
SDM
Shareddecisionmaking
www.nhivna.org
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