Nursing practice when shared decision-making related to medical treatment for children with severe motor and intellectual disabilities occurs

Abstract

 Purpose: This study aimed to describe nursing practice when shared decision-making related to medical treatment for children with severe motor and intellectual disabilities occurs. Methods: Nine nurses participated in semi-structured interviews. Data analyses were conducted using descriptive qualitative methods. Results: Nine categories were extracted. Nurses “share direction for decision-making support with the medical care team” and “seize the opportunity for parents to consider the treatment”. During the decision-making process, nurses “facilitate parent comprehension of information”, “support parents in communicating with each other and making decisions together”, “support parents in taking a step forward by reducing anxiety”, and “make parents aware of the need for treatment”. Nurses “wait until parents make a decision in parallel while remaining close to parents who vacillate between consent and refusal” and “respect the parents’ decision”. Nurses try to “build a foundation of trust with parents” for decision-making support. Conclusion: In shared decision-making related to medical treatment for children with severe motor and intellectual disabilities, nurses combine the support of quietly waiting for the parents’ decision with the support of facilitating the decision-making process, and ultimately respect the parents’ decision.