gms | German Medical Science

Background and Purpose: The current focus in EBP is on the use of research evidence and less on the individual patient’s values in the decision making process. Shared decision making (SDM) might strengthen the decision making process in EBP, especially in chronic care. We aim to discuss the relevance of SDM in chronic care and to suggest how it can be integrated in evidence-based nursing practice.

Research Focus: Literature on EBP and SDM from the databases CINAHL and PubMed with search terms ‘(shared) decision making’, ‘evidence-based’, and ‘nurs*’.

Methodological and Theoretical Focus: We described possible approaches to guide decision making and we discussed the integration of SDM with evidence-based chronic care.

Results: We identified three possible approaches to guide the decision process: the paternalistic-, the informed patient- and the shared approach. SDM can be integrated within the decision making step of EBP in chronic care. In the decision making process the degree of SDM depends on different attributes of the health care intervention: the level of research evidence, the number of available intervention options, the burden of side effects, the impact on lifestyle, the patient group values, and the impact on resources. Furthermore, the patient’s willingness to participate in SDM, the expertise of the nurse, and the context affect SDM.

Conclusions: SDM can be integrated with EBP for many chronic care decisions that comprise different attributes of health care interventions, the patient’s values, the nurse, and the context. It requires a positive attitude and specific communication skills.

Disclosure of Interest: All authors declare that they have no conflict of interest.

Funding: This study was funded by the Netherlands Organisation for Scientific Research (NWO) doctoral grant for teachers nr. 023.002.031.