Uncertainty about course of action to be taken when choice among
competing actions involves risk, loss, or challenge to values and beliefs
• Delayed decision making
• Focusing on self
• Lack of experience or interference with decision making
• Questioning personal values or beliefs while attempting to make a
• Vacillation between alternative choices
• Verbal statements describing undesirable consequences of alterna-
tive actions being considered
• Verbal expression of distress and uncertainty
• Divergent sources of informa-
• Lack of relevant information
• Moral obligations require
• Interference with decision
• Moral obligations require no
• Lack of experience with deci-
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
• Roles and relationships
• Values and beliefs
The patient will
• State feelings about the current situation.
• Discuss beneﬁts and drawbacks of treatment options.
• Make minor decisions related to daily activities.
• Accept assistance from family, friends, clergy, and other support
• Report feeling comfortable about ability to make an appropriate,
SUGGESTED NOC OUTCOMES
Decision Making; Information Processing; Participation in
INTERVENTIONS AND RATIONALES
Determine: Assess major challenges patient will face in making deci-
sions about care, as well as factors that inﬂuence patient’s present
decision-making skills. This information will be useful in establishing
Perform: Arrange patient’s environment to promote relaxation and
comfort while the patient is trying to gain control of decision making.
Assist with self-care activities while patient needs help to ensure
that ADLs are met.
Offer massage to reduce tension and assist patient to relax.
Help patient make decisions about daily activities to enhance her
feelings of control.
Help patient identify available options and possible consequences
to assist with rational, logical decision making.
Inform: Teach techniques for progressive muscle relaxation to
decrease physical and psychological signs of tension.
Attend: Encourage visits with family, friends, and clergy; provide pri-
vacy during visits to foster emotional support.
Encourage patient to express concerns about frustrations in mak-
ing decisions. Take the time to assist the patient to explore or sort
out aspects of decision making that cause him or her difﬁculty.
Manage: Offer written information, a reading list, or a referral to a
support group to ensure that patient will have reference material
when it is needed.
Refer to home health nurse for a follow-up visit in the home.
Refer to a nutritionist for information on good nutrition and ﬂuid
SUGGESTED NIC INTERVENTIONS
Active Listening; Assertiveness Training; Decision-Making Support;
Learning Facilitation; Mutual Goal-Setting
Popejoy, L. (2005). Health-related decision-making by older adults and their
families: How clinicians can help. Journal of Gerontological Nursing, 31(9),