Nursing diagnosis – READINESS FOR ENHANCED DECISION MAKING

READINESS  FOR  ENHANCED

DECISION  MAKING

DEFINITION

A pattern of choosing courses of action that is sufficient for meeting

short- and long-term health-related goals and can be strengthened

DEFINING CHARACTERISTICS

• Expresses desire to enhance decision making

• Expresses desire to enhance congruency of decisions with personal

values and goals

• Expresses desire to enhance congruency between decisions and

sociocultural goals and values

• Expresses desire to enhance risk–benefit analysis of decisions

• Expresses desire to enhance the understanding of choices

ASSESSMENT FOCUS    (Refer  to  comprehensive  assessment  parameters.)

• Coping

• Knowledge

• Communication

• Values and beliefs

EXPECTED OUTCOMES

The patient will

• Express the desire to make effective decisions.

• Verbalize decision-making goals and concerns.

• Discuss measures used to evaluate decisions.

• Make decisions that promote maximal physical, mental, social,

and psychological well-being.

• Involve family, friends, and clergy in healthcare decision making

when appropriate.

SUGGESTED NOC OUTCOMES

Decision Making; Participation in Healthcare Decisions; Self-Care:

IADLs

INTERVENTIONS AND RATIONALES

Determine: Assess usual coping strategies employed by the patient

when making decisions; determine how the patient goes about mak-

ing difficult decisions; have the patient describe several challenging

decisions he or she made in the past year. Assessment information

will help identify appropriate interventions.

Evaluate support systems available to the patient when it is neces-

sary to make decisions. Patients often need support of families or

other support systems when they are faced with major decisions.

Perform: Provide assistance with ADLs as required. As the patient

receives assistance, it is important to allow him or her to be as inde-

pendent as possible.

Make changes in the environment to reduce unnecessary stimula-

tion and promote a sense of calm.

Inform: Teach patient simple decision-making techniques and role-

play the same. Return demonstration from the patient will give

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him or her confidence that he or she can choose wisely among

options.

Educate family about the importance of allowing the patient to

think and act for himself or herself in order to give the patient a

sense of control over the present situation.

Attend: Provide emotional support and encouragement to help

improve patient’s confidence in his or her ability to make logical

decisions.

Provide patient with all necessary support during hospitalization

to prepare him and his family to continue the process of having the

patient make decisions about his own care.

Involve patient in planning and decision making. Having the abil-

ity to participate will encourage greater compliance with the treat-

ment plan.

Manage: If patient continues to have difficulty, refer to case

manager/social worker/mental health professional for continued

follow-up.

Provide appropriate assistance to the family members when they

are trying to provide; it might be helpful in working with the

patient.

SUGGESTED NIC INTERVENTIONS

Decision-Making Support; Health System Guidance; Self-Responsibility

Facilitation

Reference

Moser, A., et al. (2007, February). Patient autonomy in nurse-led shared care:

A review of theoretical and empirical literature. Journal of Advanced Nurs-
ing, 57(4), 357–365.

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