A Relational Approach to Implantable Cardioverter-Defibrillator Generator Replacement: An Integrative Review of the Role of Nursing in Shared Decision-Making.

Krystina B Lewis, Rosalie Starzomski, Lynne Young
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Abstract

Background: Implantable cardioverter defibrillator (ICD) implantation rates are increasing as advances in heart failure and arrhythmia management progress. Consequently, the number of ICD generator replacements is rising and ICD replacement is an opportune time for shared decision-making (SDM). Nurses should have distinct roles and responsibilities in SDM processes.

Objectives: To use a relational lens to localize the role of the nurse in SDM, and recommend ways in which nurses can be involved in SDM.

Methods: An integrative review of 17 articles was conducted to determine the role of nurses in SDM.

Results: Our analysis revealedfour themes that helped us articulate nurse involvement in SDM; knowledge as a basis for SDM, sharing power in the nurse-patient relationship, utilization of decisional support strategies, and communication.

Conclusion: Our findings support the participation of nurses in SDM. Nursing implications are offered, specifically for the management of patients facing ICD replacement.

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植入式心律转复除颤器发生器更换的相关方法:护理在共同决策中的作用的综合回顾。
背景:随着心力衰竭和心律失常治疗的进展,植入式心律转复除颤器(ICD)的植入率正在增加。因此,更换ICD发电机的数量不断增加,ICD更换是共享决策(SDM)的良机。护士在SDM过程中应该有明确的角色和责任。目的:运用关系视角定位护士在SDM中的角色,并推荐护士参与SDM的方式。方法:对17篇文献进行综合回顾,以确定护士在SDM中的作用。结果:我们的分析揭示了四个主题,帮助我们明确护士参与SDM;知识作为SDM的基础,在护患关系中分享权力,决策支持策略的使用,以及沟通。结论:我们的研究结果支持护士参与SDM。提供护理意义,特别是对面临ICD更换的患者的管理。
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