Shared Decision-making in Acute Myeloid Leukemia.

OBJECTIVES: Shared decision-making (SDM) is the gold standard approach to cancer treatment decision-making in the 21st century, but it is frequently misunderstood, and many clinicians do not know how to operationalize the SDM framework in their busy practices. Here we review the principles behind SDM, discuss unique aspects of acute myeloid leukemia (AML) that complicate the decision-making process, and provide one recommended framework for how to implement SDM into practice.

DATA SOURCES: Published literature and clinical experiences.

CONCLUSION: AML poses unique challenges to treatment decision-making. These challenges can be effectively addressed by following the SDM framework in practice.

IMPLICATIONS FOR NURSING PRACTICE: Nurses can play an important role in the AML treatment decision-making process. Being on the front lines of care, working most directly with patients and families, nurses are best positioned to assess understanding after treatment discussions take place, detect emotional distress, and provide empathic support as part of the SDM process.