Factors influencing nurses’ decision-making on chronic patients with complex needs

Abstract

In recent years, sociodemographic changes have increased the rate of over aging. One of its consequences is the increase in patients with multiple chronic diseases, more than 50% of the population, of which 5% will present complex needs related to chronic morbidity, recurrent admissions, difficult to control symptoms and difficulty in the process of decision making.
This is a descriptive, observational and cross-sectional study carried out in two hospitals, within the framework of a training course. The sample is of 50 nursing professionals who completed a SWOT matrix with the objective of identifying their weaknesses and strengths in relation to decision-making in the context of care for these patients, as well as the threats and opportunities of the environment.
The most prevalent weaknesses were “assent medical decisions” (82%), “indecision” (71%), caused by “ignorance of therapeutic objectives” (36%), “lack of training in comprehensive geriatric assessment” (31 %) and in “handling in difficult situations” (65%).
The strengths include “active listening” (92%, “professional experience” (82%), “ability to motivate and empathize” (72%), and “be consistent with the decisions made” (45%).
The threats of the environment include “lack of time” (94%), “high care burden” (87%) and “staff turnover” (79%).
As soon as the opportunities of the environment stand out “the therapeutic communication” (53%), and with 36%, the existence of the plans of shared indi-vidual intervention.
There are several factors that influence nursing decision making and that influ-ence care and decision making in the care of chronic patients with complex needs, so it is necessary to influence the approach to weaknesses and threats detected, as well as fostering opportunities and strengths.