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How do nurses facilitate shared decision-making in HIV care? An exploratory study of UK nurses knowledge, perspective and experience of facilitating shared decision-making in clinical practice

Michelle Croston, John McLuskey, Catrin Evans


Background, objectives and aims: Shared Decision Making (SDM) enables clinicians to promote self-management and to empower patients with long-term health conditions. While it has been reported in other health conditions, there is little empirical research on the nature and practice of SDM in HIV care. This project aimed to explore current views and practices among UK HIV nurses regarding SDM.

Methods: A mixed methods study utilised focus groups and an online survey to identify opportunities, challenges and training needs.

Results: Nurses are supportive of SDM but face patient-related, organisation and health system challenges to implement it, especially in supporting complex patients. SDM is an important aspect of nursing care for people living with HIV.

Conclusions: Nurses need more training and resources to implement SDM effectively. In order to develop such training and resources to better understand SDM in relation to HIV care, there is a need for research on patient perspectives and experiences in this area.


HIV, nurses, person-centered healthcare, shared decision-making

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Public Health England. (2015). New diagnosis, treatment and care in the UK: 2015 report. London: Public Health England.

National HIV Nurses Association (2016) Advanced practice nursing practice in HIV care: Guidelines for nurses, providers, and commisioners. London: NHIVNA.

Bravo, P., Edwards, A., Rollnick, S. & Elwyn, G. (2010). Tough decisions faced by people living with HIV: a literature review of psycho-social problems. AIDS Reviews 12, 76-88.

Coulter, A. & Collins, A. (2011). Making shared decision making a reality: No decision about me without me. London: The King’s Fund.

Department of Health. (2012). No decision about me without me: Liberating the NHS. London: HMSO.

Lee, O. & Emmanuel, E. (2013). Shared decision making to improve care and reduce costs. New England Journal of Medicine 368, 6-8.

Friesen-Storms, J.H., Bours, G.J., van der Weijden, T. & Beurskens, A.J. (2015). Shared decision making in chronic care in the context of evidence based practice in nursing. International Journal of Nursing Studies 52 (1) 393-402.

Stiggelbout, A.M., Pieterse, A.H. & De Haes, J.C. (2015). Shared decision making: Concepts, evidence, and practice. Patient Education and Counseling 98 (10) 1172-1179.

National AIDS Trust. (2012). No decision about me without me: Consultation on shared decision making (Response from National AIDS Trust, NAT). London: National AIDS Trust.

BHIVA. (2012). Standards of Care for People Living with HIV. London: British HIV Association (BHIVA).

EACS. (2014). EACS Clinical Guidelines, Version 7.1. Brussels: European AIDS Clinical Society.

Legare, F., Ratte, S., Gravel, K. & Graham, I.D. (2008). Barriers and facilitators to implementing shared decision-making in clinical practice: update of a systematic review of health professionals' perceptions. Patient Education and Counseling 73 (3) 526-535.

Shay, L.A. & Lafata, J.E. (2014). Understanding patient perceptions of shared decision making. Patient Education and Counseling 96 (3) 295-301.

Truglio-Londrigan, M., Slyer, J.T., Singleton, J.K. & Worral, P.S. (2014). A qualitative systematic review of internal and external influences on shared decision-making in all health care settings. JBI Database of Systematic Reviews & Implementation Reports 12 (5) 121-194.

Kumar, R., Korthuis, P.T., Saha, S., Chander, G., Sharp, V., Cohn, J., Moore, R. & Beach, M.C. (2010). Decision-making role preferences among patients with HIV: associations with patient and provider characteristics and communication behaviors. Journal of General Internal Medicine 25 (6) 517-523.

Beach, M.C., Roter, D.L., Saha, S., Korthuis, P.T., Eggly, S., Cohn, J., Sharp, V., Moore, R.D. & Wilson, I.B. (2015). Impact of a brief patient and provider intervention to improve the quality of communication about medication adherence among HIV patients. Patient Education and Counseling 98 (9) 1078-1083.

Laws, M.B., Beach, M.C., Lee, Y., Rogers, W.H., Saha, S., Korthuis, P.T., Sharp, V. & Wilson, I.B. (2013). Provider-patient adherence dialogue in HIV care: results of a multisite study. AIDS and Behavior 17 (1) 148-159.

Creswell, J. & Plano-Clark, V. (2007). Designing and Conducting Mixed Methods Research. Thousand Oaks, California: Sage.

Barbour, R. (2007). Doing Focus Groups. London: Sage Publications.

Richards, L. (2009). Handling qualitative data: a practical guide. London: Sage.

Boyatzis, R. (1998). Transforming qualitative data: thematic analysis and code development. London: Sage.

Bryman, A., & Burgess, R. (1994). Analysing Qualitative Data. London: Routledge.

Lincoln, Y. & Guba, E. (1985). Naturalistic Inquiry. California: Sage.

Legare, F., O'Connor, A.M., Graham, I.D., Saucier, D., Côté, L., Blais, J., Cauchon, M & Paré, L. (2006). Primary health care professionals’ views on barriers and facilitators to the implementation of the Ottawa Decision Support Framework in practice. Patient Education and Counseling 63 (3) 380-390.



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