gms | German Medical Science

Background and Purpose: Considering the demographic and societal developments in Germany, rethinking the distribution of roles in health care is urgently needed. In Germany, nurses have already been involved in patient education in a structured manner within the scope of the disease management programs for diabetes mellitus, asthma and hypertension. So far informed shared decision making (ISDM) involving nurses has not been implemented in German healthcare. However, inter-professional approaches including decision coaching led by nurses have shown promising results. Studies indicate increased participation and knowledge, but also reveal various barriers that impede implementation of these decision coaching approaches.

Methods: We will present an overview of new inter-professional and evidence-based approaches to implement nurse-lead decision coaching for diagnostic and therapeutic decision making. Chances, challenges and barriers will be discussed.

Research Focus: This symposium focuses on nurses’ new roles in decision support.

Results: The symposium will include three presentations. The first presentation comprises the outline and first result of a Cochrane review on decision coaching, prepared by a multi-national group of reviewers. The second speaker will present a cluster-randomized trial that evaluated a complex intervention on nurse led decision coaching on immunotherapy in people with multiple sclerosis. Results of a mixed methods process evaluation will be presented. The last speaker presents the results of a non-blinded cluster-randomized controlled trial in German breast care centers, that evaluated a complex intervention comprising an evidence- based decision aid combined with nurse led decision coaching for women with ductal carcinoma in situ (DCIS).

Conclusions: Elaborated strategies are needed for successful nurse-led decision coaching and to overcome system immanent barriers for the implementation of nurses´ new roles.

Programme Overview:

1.

(S. Köpke) Decision coaching for people preparing to make health care decisions – Cochrane Review

2.

(A Rahn): Decision coaching in multiple sclerosis – process evaluation results.

3.

(B. Berger-Höger): Decision Coaching in oncology: promising results and challenging barriers.
In order to implement ISDM in certified German breast care centers a complex intervention comprising an evidence-based decision aid combined with nurse led decision coaching for women with ductal carcinoma in situ (DCIS) was developed and evaluated. The results of a non-blinded cluster-randomized controlled trial in German breast care centers will be presented.

4.

(G. Meyer): Discussion and reflection