Collaborative Decision-making Process Research Articles

STAM-based methodology to prevent concurrence events in a Multi-Airport System (MAS)

Pre-tactically managing the imbalances of the network and organizing the resources of the airspace is one of the main objectives of Dynamic Demand & Capacity Balancing (dDCB). Introducing Short-term Air Traffic Flow and Capacity Management (STAM) measures such as minor ground delays or slight speed adjustments applied to a selected number of flights on the day of operations, supports the dDCB process by reducing the traffic complexity and the probability of Air Traffic Controllers interventions. This paper introduces a rolling horizon methodology for detecting concurrence events, analysing their trajectory interdependencies and applying a strategic mitigation measure that shifts the Estimated Take-Off Time (ETOT) within the assigned Calculated Take-Off Time (CTOT) window. The methodology proposes a collaborative decision-making process for a better coordination of departures from airports feeding airspace volumes with high air traffic demand. The experimental part of this paper aims at showing the potential benefits of such a STAM procedure by applying the methodology to distribute the demand of a sector located in the London Terminal Manoeuvring Area (LTMA). Experiments have considered regulated traffic scenarios where ETOT were allocated in order to reduce departure time uncertainties. Lastly, it is analysed the impact of the parameters used by the methodology to calculate the mitigation measures: safe separation criteria, look-ahead time and number of coordinated airports.

Evaluating the Process and Outcomes of Collaborative Conservation: Tools, Techniques, and Strategies

Collaborative conservation has been touted as a viable option for addressing contentious natural resource stewardship issues in a way that represents the diverse voices impacted by, and involved in, conservation decisions. Engaging meaningfully in collaborative conservation involves overcoming a unique set of challenges while also realizing opportunities. In this special issue, we use the term collaborative conservation evaluation to encompass research and evaluation related to collaborative governance and collaborative natural resource management projects, programs, or decision-making processes that leverage a participatory approach, involve multiple stakeholders, and incorporate a range of contemporary evaluation approaches. Here, we provide a series of articles and tools intended to highlight different approaches to evaluation that utilize a variety of methodologies adapted for different contexts. We intend for these articles to spark further conversation and inspire future directions in evaluating collaborative conservation for researchers and practitioners.

Deliberative Democracy and Water Management in New Zealand: a Critical Approach to Collaborative Governance and Co-Management Initiatives

This article offers a critical analysis of collaborative water governance initiatives in New Zealand that is embedded in deliberative democratic theory. The article begins with a review of the scientific and political dimensions of the country’s water quality issues. The authors then discuss collaborative governance initiatives in the Canterbury region and freshwater co-management initiatives between the Crown and Maori, the indigenous people of New Zealand. The article relates these two sets of collaborative practices linked to water policies to deliberative democracy and shows how a systemic approach to deliberation and the implementation of mini-publics could mitigate some shortcomings of collaborative water governance initiatives in New Zealand, both the problems of “wallpaper” democracy, in which the public’s engagement is relegated to superficial decisions, and the power imbalance between elites and the general public in collaborative decision-making processes. The model may also apply to other water governance efforts.

Designing successful urban regeneration strategies through a behavioral decision aiding approach

Finding a new use for abandoned buildings provides an opportunity for urban and rural regeneration as reconversion policies arrest decay processes and re-establish continuity in the territorial system, using existing buildings and thus limiting the consumption of new soil. This study combines quantitative stakeholders' analysis with Decision Aiding tools to design and evaluate alternative strategies for the regeneration of an abandoned military barrack in Italy. In particular, the paper details how the collaborative decision support process developed from the initial map of the local needs to the final assessment of five different regeneration projects. The main objective of the study is to develop a transferable framework able to support collaborative planning and decision-making processes related to urban regeneration transformations. The contribution brought by the study is twofold and refers to: (i) the development of an inclusive final recommendation based on the innovative integration of Multi Attribute Value Theory with quantitative stakeholders' analysis and (ii) the provision of a replicable working tool for policy makers and urban regeneration specialists. The study has thus an innovative value and may stimulate a cross-disciplinary use of behavioral decision analysis to support a value-based generation and evaluation of alternative solutions in complex multi-actor decision making settings.

Development of a Dementia-Focused End-of-Life Planning Tool: The LEAD Guide (Life-Planning in Early Alzheimer's and Dementia).

Background and ObjectivesTo address the unique characteristics of Alzheimer’s disease and related dementias (ADRD) that complicate end-of-life (EOL), we created, refined, and validated a dementia-focused EOL planning instrument for use by healthy adults, those with early-stage dementia, family caregivers, and clinicians to document EOL care preferences and values within the current or future context of cognitive impairment.Research Design and MethodsA mixed-method design with four phases guided the development and refinement of the instrument: (1) focus groups with early-stage ADRD and family caregivers developed and confirmed the tool content and comprehensiveness; (2) evaluation by content experts verified its utility in clinical practice; (3) a sample of healthy older adults (n = 153) and adults with early-stage ADRD (n = 38) completed the tool, whose quantitative data were used to describe the psychometrics of the instrument; and (4) focus groups with healthy older adults, family caregivers, and adults with early-stage ADRD informed how the guide should be used by families and in clinical practice.ResultsQualitative data supported the utility and feasibility of a dementia-focused EOL planning tool; the six scales have high internal consistency (α = 0.66–0.89) and high test–rest reliability (r = .60–.90). On average, both participant groups reported relatively high concern for being a burden to their families, a greater preference for quality over length of life, a desire for collaborative decision-making process, limited interest in pursuing life-prolonging measures, and were mixed in their preference to control the timing of their death. Across disease progression, preferences for location of care changed, whereas preferences for prolonging life remained stable.Discussion and ImplicationsThe LEAD Guide (Life-Planning in Early Alzheimer’s and Dementia) has the potential to facilitate discussion and documentation of EOL values and care preferences prior to loss of decisional capacity, and has utility for healthy adults, patients, families, providers, and researchers.

Towards an Integrated Biodiversity Technology Program Supporting Transparent Decision Making in Australia

Effective management of our natural world under current and future conditions requires efficient, collaborative and complementary planning and decision-making processes with clear lines of accountability. While there has been significant progress in establishing national databases for the management of species observation data, these only represent samples of a species' total distribution. The need and challenge therefore is to model these point-based observation data to obtain estimates or projections of the total range and distribution of the species. Such Species Distribution Models (SDMs), also known as Environmental Niche Models (ENMs), and the geographic data (or “maps”) they generate, provide vital information needed by governments at all levels to meet various policy and statutory responsibilities and obligations. SDMs quantify the response of species occurrence to environmental conditions described by variables such as climate, substrate, productivity and vegetation. The outcomes of an SDM can be used to identify locations and regions with potentially suitable environmental conditions for a species, as well as assess how species may respond to projected future climate changes or habitat loss. While SDMs are widely used in many decision- and policy-making programs, investment in species distribution information has been fragmented and limited. In Australia, three different government departments joined forces with the Atlas of Living Australia and the Biodiversity and Climate Change Virtual Laboratory to develop a standard framework for modelling threatened species distributions for use in policy and environmental decision-making. The pilot program that will be conducted throughout 2019 includes three complementary pillars: An expert panel with both researchers and government practitioners who will review current SDM practices used in government and develop a set of best-practice methods. A technology program that includes the development of a new modelling platform that implements the best-practice methods for transparent and reproducible SDMs for decision making as established by the expert panel. Additionally, there will be an online portal for publishing ecological model outputs in a searchable catalogue to enhance cross-jurisdiction collaborations. Establishment of a training and skill development program to upskill decision makers using the new tools and methodology in practice. An expert panel with both researchers and government practitioners who will review current SDM practices used in government and develop a set of best-practice methods. A technology program that includes the development of a new modelling platform that implements the best-practice methods for transparent and reproducible SDMs for decision making as established by the expert panel. Additionally, there will be an online portal for publishing ecological model outputs in a searchable catalogue to enhance cross-jurisdiction collaborations. Establishment of a training and skill development program to upskill decision makers using the new tools and methodology in practice. This presentation will showcase the outcomes of this program and highlight how digital infrastructure can enhance decision making. In this case specifically, the collaboration across government departments ensures a) a consistent approach across jurisdictions, b) an increase in model quality, thereby leading to a decrease in unnecessary survey or consultation efforts, c) an increase in suitability, robustness and reproducibility of SDMs, and d) increased advocacy and coordination in national programs and resources.

Students\u2019 collaborative decision-making processes in defining and classifying quadrilaterals: a semiotic/dialogic approach

In this paper, we take a semiotic/dialogic approach to investigate how a group of UK 12–13-year-old students work with hierarchical defining and classifying quadrilaterals. Through qualitatively analysing students’ decision-making processes, we found that the students’ decision-making processes are interpreted as transforming their informal/personal semiotic representations of “parallelogram” (object) to more institutional ones. We also found that students’ decision-making was influenced by their inability to see their peers’ points of view dialogically, i.e., requiring a genuine inter-animation of different perspectives such that there is a dialogic switch, and individuals learn to see the problem “as if through eyes of another,” in particular collectively shared definitions of geometrical shapes.

A Learning Loop Model of Collaborative Decision-Making in Chronic Illness

Shared decision-making is a core attribute of quality health care that has proved challenging to implement and assess in pediatric practice. Current models of shared decision-making are limited, including their capacity to incorporate multiple stakeholders; to integrate downstream effects of subacute or minor decisions; and to account for the context(s) in which such decisions are being made and enacted. Based on a review of literature from organizational psychology, cognitive sciences, business, and medicine, we propose an iterative decision-making model of care planning and identify targets at several levels of influence warranting measurement in future studies. Our learning loop model posits the relationship between pediatric patients, their parents, and their clinicians as central to the collaborative decision-making process in the setting of chronic illness. The model incorporates the evolution of both context and developmental capacity over time. It suggests that “meta-learning” from the experience of and outcomes from iterative decision is a key factor that may influence relationships and thus continued engagement in collaboration by patients, their parents, and their clinicians. We consider the model in light of the needs of children with special health care needs, for whom understanding the ongoing iterative effects of decision making and clinician−parent−child dynamics are likely to be particularly important in influencing outcomes.

Assessment of synchronous interactive devices for BIM project coordination: Prospective ergonomics approach

Abstract In the last years, BIM has gained interest across the construction sector in Europe. 3D coordination, i.e. the task aiming at comparing several 3D models in order to reduce problems and conflicts, is often identified as a new mission. It is associated with the authoring, use and quality control in relation with the management of digital information models produced in so-called BIM projects. 3D coordination is an emergent business involving new practices, contractual standards and associated devices and software, thus requiring appropriate research approaches involving the understanding of Information Technology in human environments to address it. Based on a prospective ergonomics methodology, the authors analyse the synchronous co-located 3D coordination meeting and focus on three research questions: 1) What is the current 3D coordination task?, 2) How are the usual interaction and visualization devices supporting synchronous co-located 3D coordination meeting perceived by users?, and 3) How could a new 3D coordination meeting support system strengthen collaborative decision-making process in synchronous co-located context? A survey, followed by a controlled laboratory experiment, provides results on the conceptualization of the BIM coordination process as well as on the devices that will support the related synchronous co-located meetings. The findings highlight the usefulness of touch-based and multi-users displays for a better engagement of teams. However the study also documents the pain points associated with the use of such devices in collective settings.

Spiritual Discernment, the Incorporated Organization, and Corporate Law: The Case of Quaker Business Method

The purpose of this paper is to examine the extent to which practices from the spiritual traditions—in our case, spiritual discernment—may offer opportunities for management innovation in non-religious organizations in designing collaborative and participative decision-making processes. We examine the case of a spiritual discernment practice associated with the Religious Society of Friends (Quakers) in the UK—known as the Quaker Business Method (QBM)—to help illuminate the opportunities of spiritual discernment in private limited companies. Given that the majority of non-religious, trading organizations are structured as private limited companies, our paper addresses the extent to which QBM can be utilized by such entities. Thus, we bring religion and corporate law into conversation to address this under-explored terrain. We find that embedding many elements of Quaker spiritual discernment in private limited companies pose non-trivial challenges. However, many of these challenges can be overcome so long as those involved in managing and owning organizations actively engage with corporate law, and specifically consider the benefits of adopting bespoke articles of association or entering into a separate shareholder agreement to reflect the practice of spiritual discernment. We necessarily adopt a practice-orientated perspective, and conclude by proposing new pathways for future research.

A mixed-methods approach to strategic planning for multi-benefit regional water infrastructure

Finding regional solutions for water infrastructure and other environmental management challenges requires coordination, communication, and a shared understanding among different stakeholders. To develop a more versatile and collaborative decision-making process for nutrient management in the San Francisco Bay Area, we used a mixed-methods approach consisting of stakeholder analysis with cluster analysis, multi-criteria decision analysis (MCDA), and scenario planning. These methods allowed us to identify agreements and disagreements in stakeholder objectives and preferences, clarify ways in which different options could meet the goals of diverse stakeholders, and elucidate how scientific uncertainty about technical performance and future conditions could affect management strategies. Results of the analysis indicate that several non-conventional nutrient management options like constructed wetlands and increased water recycling for irrigation met the goals of many stakeholders under a variety of future scenarios. A comparison of MCDA results with a more traditional ‘cost-efficiency’ measure (i.e., optimizing for the lowest cost per mass of nutrients removed) revealed little correlation between the two methods for stakeholders who expressed a preference for co-benefits of management options such as increased water supply and nutrient recovery for fertilizer use. The method also allowed us to identify key areas of disagreement (e.g., the relative importance of constructing infrastructure that would not be affected by sea level rise) that should find regulatory or professional consensus before advancing with decision-making. This mixed-methods approach is time-consuming and requires specific expertise that is not always available to stakeholders. The development of more efficient preference elicitation and interaction procedures would increase the likelihood that decision-makers would make the extra effort required to use this potentially powerful method. Nonetheless, the mixed-methods approach had several important advantages over more traditional strategic planning methods including its ability to stimulate discussions amongst stakeholders who do not regularly interact, support collaborative planning, and encourage multi-benefit solutions.

A case study activity to assess nursing students′ perceptions of their interprofessional healthcare team’s collaborative decision-making process

Abstract Stronger interprofessional team collaboration is associated with higher satisfaction with decision-making processes, but nurses are most likely to feel low satisfaction with team decision-making. Because interprofessional teams should make inclusive care plan decisions using consensus, a semester-long, interprofessional case study activity included student health profession team creation of a hospital discharge plan for a web-based patient. Interprofessional student teams from nursing and five other health professions participated in the activity that used an ‘adapted’ nursing case study as an interprofessional case. Upon completion, it was hoped nursing student participants would report high perceptions of collaboration and satisfaction with their team decision-making process. Post-activity, overall scores on the Collaboration and Satisfaction about Care Decisions instrument indicated that nursing student participants perceived collaboration levels as relatively high or acceptable and were generally satisfied with their team decision-making process. However, no mean scores were in the higher or most positive levels. More interventions focusing on team process and decision-making may assist in the delivery of effective patient-centered, team-based care. Case studies from the National League for Nursing and Community College of Philadelphia, Advancing Care Excellence for Seniors website can easily be adapted as interprofessional.

Enhancing Rural Population Health Care Access and Outcomes Through the Telehealth EcoSystem™ Model.

The article highlights the Telehealth EcoSystem™ model, a holistic cross-sector approach for socioeconomic revitalization, connectivity, interoperability and technology infrastructure development to address health equity for rural underserved communities. Two guiding frameworks, Community & Economic Development (CED) and Collective Impact, provided the foundation for the Telehealth EcoSystem™ model. Public and private organizational capacities are addressed by comprehensive healthcare and social service delivery through stakeholder engagement and collaborative decision-making processes. A focus is maintained on economic recovery and policy reforms that enhance population health outcomes for individuals and families who have economic challenges.The Telehealth EcoSystem™ utilizes an intranet mechanism that enables a range of technologies and electronic devices for health informatics and telemedicine initiatives. The relevance of the intranet to the advancement of health informatics is highlighted. Best practices in digital connectivity, HIPAA requirements, electronic health records (EHRs), and eHealth applications, such as patient portals and mobile devices, are emphasized. Collateral considerations include technology applications that expand public health services.The ongoing collaboration between a social science research corporation, a regional community foundation and an open access telecommunications carrier is a pivotal element in the sequential development and implementation of the Telehealth EcoSystem™ model in the rural southeastern region community.

A system-wide transformation towards integrated care in the Basque Country: A realist evaluation

Introduction In 2010, in a context of severe economic recession, the Basque Government launched the Strategy to tackle the challenge of chronicity in the Basque Country to transform the Basque health system to cope with the challenges of chronicity, ageing, health system fragmentation and sustainability in the long run. Methods A realist evaluation has been conducted, and through a combination of research methods, information has been analysed to identify context, mechanisms and outcomes. The research provides a snapshot of the experience of a system-wide, complex health system transformation, which aims to identify ‘what has worked, for whom and under what circumstances’. Twenty-two semi-structured interviews held between June 2015 and December 2016, allowed us to obtain both retrospective and real-time accounts on the transformation phenomenon. Results Research pointed out that system-wide transformation requires time, effort, leadership, vision and narrative, as well as commitment, inclusiveness, collaborative decision-making processes with local implementers, ‘muddling through’ and constant learning. Key levers to shake and shift the health and social care systems towards closer alignment, coordination and integration to meet the needs of people include promoting collaborative relationships between health professionals to ensure care continuity, developing new staff roles, investing in integrated electronic health records, stratifying the population by risk and facilitating bottom-up innovation. Discussion Research has shown that system-wide changes in health and social care have been viable in the Basque Health System, although the interplay between context, mechanisms and outcomes is more complex than expected, leading to many unexpected factors, patterns and relationships.

Functional Status and Survival After Breast Cancer Surgery in Nursing Home Residents

Breast cancer surgery, the most common cancer operation performed in nursing home residents, is viewed as a low-risk surgical intervention. However, outcomes in patients with high functional dependence and limited life expectancy are poorly understood. To assess the overall survival and functional status changes after breast cancer surgery in female nursing home residents stratified by surgery type. This study used Medicare claims from 2003 to 2013 to identify 5969 US nursing home residents who underwent inpatient breast cancer surgery. Using the Minimum Data Set Activities of Daily Living (MDS-ADL) summary score, this study examined preoperative and postoperative function and identified patient characteristics associated with 30-day and 1-year mortality and 1-year functional decline after surgery. Cox proportional hazards regression was used to estimate unadjusted and adjusted hazard ratios (HRs) of mortality. Fine-Gray competing risks regression was used to estimate unadjusted and adjusted subhazard ratios (sHRs) of functional decline. Statistical analysis was performed from January 2016 to January 2018. Functional status and death. From 2003 to 2013, a total of 5969 female nursing home residents (mean [SD] age, 82 [7] years; 4960 [83.1%] white) underwent breast cancer surgery: 666 (11.2%) underwent lumpectomy, 1642 (27.5%) underwent mastectomy, and 3661 (61.3%) underwent lumpectomy or mastectomy with axillary lymph node dissection (ALND). The 30-day mortality rates were 8% after lumpectomy, 4% after mastectomy, and 2% after ALND. The 1-year mortality rates were 41% after lumpectomy, 30% after mastectomy, and 29% after ALND. Among 1-year survivors, the functional decline rate was 56% to 60%. The mean MDS-ADL score increased (signifying greater dependency) by 3 points for lumpectomy, 4 points for mastectomy, and 5 points for ALND. In multivariate analysis, poor baseline MDS-ADL score (range, 20-28) was associated with a higher 1-year mortality risk (lumpectomy: HR, 1.92 [95% CI, 1.23-3.00], P = .004; mastectomy: HR, 1.80 [95% CI, 1.35-2.39], P < .001; and ALND: HR, 1.77 [95% CI, 1.46-2.15], P < .001). After multivariate adjustment, preoperative decline in MDS-ADL score (lumpectomy: sHR, 1.59 [95% CI, 1.25-2.03], P < .001; mastectomy: sHR, 1.79; [95% CI, 1.52-2.09], P < .001; and ALND: sHR, 1.72 [95% CI, 1.56-1.91], P < .001) and cognitive impairment (lumpectomy: sHR, 1.27 [95% CI, 1.03-1.56], P = .02; mastectomy: sHR, 1.26 [95% CI, 1.09-1.45], P = .002; and ALND: sHR, 1.14 [95% CI, 1.04-1.24], P = .003) were significantly associated with 1-year functional decline across all breast cancer surgery groups. For female nursing home residents who underwent breast cancer surgery, 30-day mortality and survival as well as 1-year mortality and functional decline were high. The 1-year survivors had significant functional decline. This study's findings suggest that this information should be incorporated into collaborative surgical decision-making processes.

Exploring spatially-aware cross-device interaction techniques for mobile collaborative sensemaking

Abstract The collaborative decision-making process is traditionally supported by multi-user interfaces, such as large multi-touch screens or interactive tabletops for accessing, relating and comparing different data sources. Since such multi-user interfaces are typically expensive and unavailable outside dedicated environments (e.g. labs, smart rooms), recent works have proposed “bring your own device” approaches that allow users to join their mobile devices (e.g. smartphones, tablets) in an ad-hoc manner to temporarily create multi-user cross-device systems. Such approaches can be enabled by spatially-aware cross-device interactions that have only been explored for simple operations. We conducted a three-step research study involving a total number of 65 users in 18 groups, in order to propose a composition paradigm that offers three interaction techniques for performing more complex operations, such as forwarding to multiple devices queries or query results or aggregating and visualizing search results across device boundaries.

Framing natural assets for advancing sustainability research: translating different perspectives into actions

Sustainability is a key challenge for humanity in the context of complex and unprecedented global changes. Future Earth, an international research initiative aiming to advance global sustainability science, has recently launched knowledge–action networks (KANs) as mechanisms for delivering its research strategy. The research initiative is currently developing a KAN on “natural assets” to facilitate and enable action-oriented research and synthesis towards natural assets sustainability. ‘Natural assets’ has been adopted by Future Earth as an umbrella term aiming to translate and bridge across different knowledge systems and different perspectives on peoples’ relationships with nature. In this paper, we clarify the framing of Future Earth around natural assets emphasizing the recognition on pluralism and identifying the challenges of translating different visions about the role of natural assets, including via policy formulation, for local to global sustainability challenges. This understanding will be useful to develop inter-and transdisciplinary solutions for human–environmental problems by (i) embracing richer collaborative decision processes and building bridges across different perspectives; (ii) giving emphasis on the interactions between biophysical and socioeconomic drivers affecting the future trends of investments and disinvestments in natural assets; and (iii) focusing on social equity, power relationships for effective application of the natural assets approach. This understanding also intends to inform the scope of the natural asset KAN’s research agenda to mobilize the translation of research into co-designed action for sustainability.

A system dynamics model for supporting decision-makers in irrigation water management

Water management is a controversial environmental policy issue, due to the heterogeneity of interests associated with a shared resource and the increasing level of conflict among water uses and users. Nowadays, there is a cumulative interest in enhancing multi-stakeholder decision-making processes, overtaking binding mercantile business, in water management domain. This requires the development of dynamic decision-aiding tools able to integrate the different problem frames held by the decision makers, to clarify the differences, to support the creation of collaborative decision-making processes and to provide shared platforms of interactions. In literature, these issues are faced by concepts such as Ostrom's action arena and Ostanello-Tsoukiàs’ interaction space (IS). The analysis of the interactions structure and of the different problem framing involved are fundamental premises for a successful debate for the management of a common-pool resource. Specifically, the present paper suggests a dynamic evolution of the IS, highlighting its criticalities. It develops an alternative perspective on the problem, using a System Dynamics Model (SDM), exploring how different actions can influence the decision-making processes of various stakeholders involved in the IS. The SDM has been implemented in a multi-stakeholders decision-making situation in order to support water management and groundwater protection in the agricultural systems in the Capitanata area (Apulia region, Southern Italy).

Multi-stakeholder Partnerships for Sustainability: Designing Decision-Making Processes for Partnership Capacity

To address the prevalence and complexities of sustainable development challenges around the world, organizations in the business, government, and non-profit sectors are increasingly collaborating via multi-stakeholder partnerships. Because complex problems can be neither understood nor addressed by a single organization, it is necessary to bring together the knowledge and resources of many stakeholders. Yet, how these partnerships coordinate their collaborative activities to achieve mutual and organization-specific goals is not well understood. This study takes an organization design perspective of collaborative decision-making processes to explore how they impact the effectiveness of multi-stakeholder partnerships. We compare the decision-making processes of 94 sustainability-focused multi-stakeholder partnerships and find that collaborative decision-making has an indirect and positive impact on partnership capacity through systems that keep partners informed, coordinate partner interactions, and facilitate ongoing learning. The implications of this study for multi-stakeholder partnership research and practice are that partnership capacity is contingent on the design of decision-making processes, as well as internal mechanisms that coordinate and monitor collaborative activities.

Are women empowered to make decisions about the use of antidepressants in pregnancy?

Background Untreated depression is related to maternal mortality and morbidity. The most frequent treatment is antidepressant medication, but studies have shown that women find decisions about the use of antidepressants in pregnancy difficult and confusing. Aim To explain if women are empowered to make decisions around the use of antidepressants in pregnancy. Methods A literature review was conducted using CINAHL Complete, Intermid, Proquest and Discover More. Findings Information provision was inadequate and women experienced decisional conflict. Women wanted to be involved in a collaborative decision-making process. Conclusions Women want to be provided with clear and accurate information and prefer to collaborate when making decisions about antidepressants in pregnancy. More research is needed to explore demographic gaps within population samples, and women's experiences of decision-making about antidepressant usage. Undergraduate and postgraduate health education should include conversation skills training, associated with collaborative discussion and informed choice.