Involvement In Decision Research Articles

Laissez-faire leadership: a comprehensive systematic review for effective education practices

This analysis addresses the knowledge gap on laissez-faire leadership in organizations. After reviewing 64 articles through the systematic literature review, the study finds that laissez-faire leadership, marked by minimal decision-making involvement, is generally associated with negative outcomes like reduced employee satisfaction and productivity. However, its impact can vary based on context, potentially fostering creativity in highly skilled and motivated teams. The study emphasizes the need for judicious application of this leadership style and suggests that school managers should discern when to use it, considering its suitability for different types of educators. Overall, the research contributes valuable insights for leaders aiming to optimize leadership strategies in diverse contexts.

Exploring Patient Empowerment in Major Depressive Disorder: Correlations of Trust, Active Role in Shared Decision-Making, and Symptomatology in a Sample of Italian Patients.

Background/Objectives: Empowerment in medicine and psychiatry involves patients gaining control over health-related decisions, improving treatment adherence, outcomes, and satisfaction. This concept is especially significant in psychiatric care due to the complex challenges of mental health conditions, including stigma and impairment of emotional and cognitive functioning. We aim to investigate the correlations between patient trust, decision-making involvement, symptom severity, and perceived empowerment among individuals with Major Depression. Methods: Patients with Major Depressive Disorder were recruited in the "Policlinico G. Rodolico" psychiatry outpatient clinic from November 2022 to June 2023. Inclusion criteria: ages 18-65, ability to consent, stable condition, psychiatric medication history, and recent consultation. Exclusion criteria: psychotic features, bipolar disorder, substance abuse, high suicide risk, and severe comorbidities. Measures included the User Scale for Measuring Empowerment in Mental Health Services (SESM), Trust in Oncologist Scale (TiOS), Clinical Decision-Making Style for Patients (CDMS-P), and Hamilton Depression Rating Scale (HAM-D). Analysis used Kendall's Tau correlation and Two-One-Sided Tests procedure. Results: Seventy-three patients completed the study. No relationship was found between decision-making involvement and perceived empowerment (τ = -0.0625; p = 0.448), or between trust in psychiatrists and empowerment (τ = 0.0747; p = 0.364). An inverse correlation existed between patient involvement in therapy management and trust (τ = -0.2505; p = 0.002). Depression severity inversely correlated with empowerment (τ = -0.2762; p = <.001), but not with trust or decision-making involvement. Conclusions: The lack of significant correlations suggests that decision-making involvement and trust alone may not suffice to enhance empowerment. Trust may encourage patient passivity, while skepticism might drive active involvement. Higher empowerment is associated with less depressive symptoms, highlighting its potential connection with patient outcomes.

Generative artificial intelligence (GenAI) and decision-making: Legal & ethical hurdles for implementation in mental health

This article argues that significant risks are being taken with using GenAI in mental health that should be assessed urgently. It recommends that guidelines for using generative artificial intelligence (GenAI) in mental health care must be established promptly. Currently, clinicians using chatbots without appropriate approval risk undermining legal protections for patients. This could harm the patient and undermine the standards of the profession, undermining trust in an area where human involvement in decision-making is critical. To explore these concerns, this paper is divided into three parts. First, it examines the needs of patients in mental health. Second, it explores the potential benefits of GenAI in mental health and highlights the risks of its use as it pertains to patient needs. Third, it notes the ethical and legal concerns around data use and medical liability that require careful attention. The impact of the European Union's (EU) Artificial Intelligence Act (AI-Act) is also considered. It will be seen that these laws are insufficient in the context of mental health. As such, the paper recommends that guidelines should be developed to help resolve the existing legal gaps until codified rules are established.

Disclosure of true medical information: the case of Bangladesh

BackgroundTruth-telling in health care is about providing patients with accurate information about their diagnoses and prognoses to enable them to make decisions that can benefit their overall health. Physicians worldwide, especially in the United Kingdom (U.K.) and the United States (U.S.), openly share such medical information. Bangladesh, however, is a Muslim-majority society with different social norms than Western societies. Therefore, we examined whether Muslim culture supports truth disclosure for patients, particularly how and to what extent medical information about life-threatening diseases is provided to patients in Bangladesh.MethodsThis was a phenomenological qualitative study. We conducted thirty in-depth interviews with clinicians, nurses, patients and their relatives at Shaheed Suhrawardy Medical College Hospital in Dhaka, Bangladesh. We also used observations to explore interactions between patients, families and healthcare professionals regarding their involvement in medical decisions and truth disclosure issues. NVivo software was used to identify common themes, and a thematic analysis method was utilised to analyse the datasets.ResultsThis study identified three recurring themes relevant to the ethics and practice of truth disclosure: best interest rather than autonomy, the ambivalent value of deception and who understands what. The participants revealed that physicians often withhold fatal medical prognoses from terminally ill patients to ensure the best healthcare outcomes. The results indicate that deception towards patients is commonly accepted as a means of reducing burden and providing comfort. The participants opined that true medical information should be withheld from some patients, assuming that such disclosures may create a severe burden on them. Whether or to what extent medical information is disclosed primarily depends on a family’s wishes and preferences.ConclusionsWhile truth disclosure to patients is considered an ethical norm in many cultures, such as in the U.K. and the U.S., the practice of concealing or partially revealing severe medical prognoses to patients is an actual medical practice in Bangladeshi society. This study emphasises the importance of recognising a patient’s active involvement and respecting the cultural values that shape family involvement in medical decision-making. These findings may have significant policy and practical implications for promoting patient autonomy within Bangladeshi family dynamics and religious-based cultural values.

From neighbour to member: Assessing Moldova’s EU membership perspectives

This article examines Moldova’s prospective membership in the European Union (EU) in the wake of the EU’s renewed enlargement drive which was prompted by Russia’s 2022 invasion of Ukraine. It explores the dynamics shaping Moldova’s accession path, spotlighting obstacles to integration that official reports appear to overlook or underplay. The article compares EU and Moldovan documents, civil society reports, and insights from interviews with Moldovan officials and civil society representatives to gain a nuanced picture of the evolving situation. Attention is also given to the distinct characteristics of the currently unfolding enlargement process, including its sense of urgency and geopolitical significance which have led to calls for an expedited or ‘fast-track’ accession. Findings note that despite Moldova’s impressive progress in aligning with EU standards in many areas, substantial hurdles in justice reform, combating corruption and de-oligarchisation persist. Incomplete public administration reforms, uneven civil society involvement in decision-making, and issues associated with the Transnistria conflict also have consequences for Moldova’s EU prospects, especially if an expedited version of enlargement occurs.

Defining the growth paths of strategic scientists based on case studies

In this paper, 18 scientists from China and other countries were selected for consideration as case studies of ‘strategic scientists’. They were chosen according to their involvement in science and technology policy decision-making, development of key and advantageous fields, creation of new disciplines, construction of academic traditions, and intersections between science and industry. On this basis, we found that the growth paths of strategic scientists can be divided into three phases: as talented young scientists, as gatekeepers in related disciplines or research fields, and as consultants for national science and technology decision-making. Based on this trichotomy, we explored the characteristics of strategic scientists and the conditions required for their growth in each phase. Finally, policy suggestions are proposed for the cultivation and use of strategic scientists.

Enhancing highland ecosystems in East Hararge, Ethiopia: evaluating intervention strategies for species diversity, soil organic carbon stock, and carbon sequestration

Forest loss and soil degradation pose significant challenges globally, particularly in developing nations like Ethiopia. Various intervention strategies have been implemented to rehabilitate degraded ecosystems. However, research gaps exist in understanding the most effective approaches, particularly in highland ecosystems. This study aimed to evaluate the effectiveness of different intervention strategies on species diversity and carbon stock in the West Hararghe zone, specifically at the Doba district Hades site. The data was collected from 5 February 2022 to 10 December 2022. The study area was characterized by systematic plots and transects to assess vegetation diversity and soil properties across four intervention categories: (physical; only soil and water conservation structures were used, enclosure; only animal and human interaction was restricted, biological; only different tree species were planted, biophysical; both soil water conservation and tree planting were used). Soil samples were collected at different depths, and biomass estimation was conducted using established formulas. Statistical analyses, including one-way ANOVA and post-hoc tests, were performed to test the level of significance. Biophysical interventions exhibited the highest species diversity index (SDI) (4.65 ± 1.21), followed by enclosure interventions (1.68 ± 0.58), while physical interventions recorded the lowest SDI (0.63 ± 0.18). Enclosure interventions led to the highest soil organic carbon (SOC) stocks at 40.13 t C ha−1, followed by biophysical interventions at 39.26 t C ha−1. Physical interventions resulted in the lowest SOC stocks at 23.9 t C ha−1, underscoring their potential for carbon sequestration. Biophysical interventions, which include both above-ground and below-ground biomass, showed significant carbon stock accumulation, totaling 173.8 t C ha−1 (39.26 t C ha−1 from SOC and 114.6 t C ha−1 from biomass), highlighting their effectiveness in enhancing ecosystem resilience. Other studies support these findings, underscoring the importance of context-specific approaches and long-term monitoring for sustainable land management. Enclosure and biophysical interventions emerge as promising strategies for enhancing species diversity and soil health, as well as promoting carbon sequestration in highland ecosystems. These findings emphasize the need for informed decision-making and community involvement in ecosystem restoration efforts to achieve meaningful and lasting impacts.

Definition and recommendations of advance care planning: A Delphi study in five Asian sectors.

In Confucian-influenced Asian societies, explicit end-of-life conversations are uncommon and family involvement in decision-making is crucial, which complicates the adoption of culturally sensitive advance care planning. To develop a consensus definition of advance care planning and provide recommendations for patient-centered and family-based initiatives in Asia. A five-round Delphi study was performed. The rating of a definition and 84 recommendations developed based on systematic reviews was performed by experts with clinical or research expertise using a 7-point Likert scale. A median = 1 and an inter-quartile range = 0-1 were considered very strong agreement and very strong consensus, respectively. The Delphi study was carried out by multidisciplinary experts on advance care planning in five Asian sectors (Hong Kong/Japan/Korea/Singapore/Taiwan). Seventy-seven of 115 (67%) experts rated the statements. Advance care planning is defined as "a process that enables individuals to identify their values, to define goals and preferences for future medical treatment and care, to discuss these values, goals, and preferences with family and/or other closely related persons, and health-care providers, and to record and review these preferences if appropriate." Recommendations in the domains of considerations for a person-centered and family-based approach, as well as elements, roles and tasks, timing for initiative, policy and regulation, and evaluations received high levels of agreement and consensus. Our definition and recommendations can guide practice, education, research, and policy-making in advance care planning for Asian populations. Our findings will aid future research in crafting culturally sensitive advance care planning interventions, ensuring Asians receive value-aligned care.

Combining Default Choices and an Encounter Decision Aid to Improve Tobacco Cessation in Primary Care Patients: A Pragmatic, Cluster-Randomized Trial.

Primary care providers (PCPs) prescribe less often treatments for smoking cessation than for other major risk factors. We assessed the effect of training PCPs to offer smoking cessation treatments to current smokers as the default choice using an encounter decision aid (DA) on smoking cessation. Pragmatic, cluster-randomized controlled trial with PCPs in private practice in Switzerland and France. The intervention was a half-day course teaching PCPs the default choice approach using a DA. Control PCPs received a 1-h refresher training on smoking cessation aids. PCPs recruited daily smokers seen for routine care. The primary outcome was self-reported, 7-day, point prevalence smoking abstinence at 6 months. Secondary outcomes were quit attempts and use of smoking cessation aids at 3 weeks, 3 months, and 6 months, and a patient-reported measure of shared decision-making (CollaboRATE scale 1-10, higher scores = more involvement). Forty-two PCPs completed the training (76% Swiss) and recruited 287 current smokers (105 intervention group, 182 control group), with 51% women, mean age 48 (SD, 2.6), 77% who smoked <20 cigarettes/day, and 221 who responded at 6 months follow-up (77%). The intervention did not affect self-reported smoking abstinence rate at 6 months (9.5% intervention and 10.4% control groups, respectively; OR 0.88 (95%CI 0.37-2.10). It did however increase the number of quit attempts at 3 weeks (OR 2.09, 95%CI 1.04-4.20) and the use of smoking cessation aids at the 3-week and 3-month follow-ups (OR 2.57, 95%CI 1.21-5.45 and OR 2.00, 95%CI 1.11-3.60, respectively). The mean CollaboRATE score was 8.05/10 in the intervention group and 7.28/10 in the control group (p=0.02), reflecting more patient involvement in decision-making. Training PCPs to use a decision aid did not improve smoking abstinence rate, despite short-term increases in quit attempts and use of smoking cessation aids. It improved patient involvement in decision-making. ClinicalTrials.gov identifier: NCT04868474.

Analysis of Natural Resources Contracts Related to Article 33 Paragraph 2 and Paragraph 3 of the 1945 Constitution

This article aims to identify challenges in the implementation of Article 33 of the 1945 Constitution in the context of the current global economy and offer a policy reform perspective to align natural resource management practices with the spirit of the constitution. Qualitative research methods are used by reviewing related scientific literature. The findings show a discrepancy between the principle of state control over natural resources and the practice of market liberalization. Key challenges include conflicts between state and market management, neglect of environmental conservation, and misalignment with global commitments to sustainability. To address these challenges, policy reforms are needed that integrate Article 33 principles in regulation, emphasize environmental sustainability, and be consistent with global commitments and public involvement in decision-making. This reform aims to ensure that the management of natural resources complies with the spirit of the constitution and provides maximum benefits for the welfare of the people and environmental sustainability. With these measures, Indonesia can more effectively align natural resource management practices with constitutional principles and achieve better welfare for the people and protect the environment.

Building Political Agreements: Pragmatic and Responsive Decision-Makers

Are politicians willing to betray their ideology, party, voters, and/or own principles to reach agreements with rivals? Focusing on the case of Spain, this article shows that there are two types of parliamentarians: those who are purely practical when making decisions (pragmatic) and those who consider their voters and electoral program in that process (responsive). We use latent class analyses to identify such profiles and conduct multinomial regression analyses to examine who are the most likely to be responsive or pragmatic parliamentarians. Our findings suggest that the former tend to have populist attitudes, support citizen involvement in decision-making, reject expert involvement in the political process, and show high levels of affective polarization. In the concluding section, we discuss how the profile of decision-makers exposes tensions in the functioning of democracy.

Investigating Pathways Linking of Women's Education Status and Empowerment to Intimate Partner Violence Among Married Women in Sri Lanka: A Structural Equation Modeling Approach.

In Sri Lanka, intimate partner violence (IPV) remains a major concern, particularly for married women. Women's education and empowerment are significant contributors to IPV. Despite this, there have been no recent studies exploring the complex relationship between education and multidimensions of empowerment in relation to IPV in Sri Lanka. Therefore, this research addresses this gap by exploring the complex pathways connecting married women's education and multidimensional empowerment to IPV. Using data from the 2019 Sri Lankan Women's Wellbeing Survey, this study included 1,165 married women. A path analysis based on structural equation modeling (SEM) was used to examine the complex interplay between distinct empowerment domains and IPV. The SEM results revealed both direct and indirect effects of women's education and empowerment on IPV experiences. Education is positively linked to age at marriage, employment status, and husbands' educational level, while inversely associated with accepting attitudes toward violence. Age at marriage plays a major role as a mediator, mediating the relationship between women's education and their involvement in decision-making, and the relationship between husbands' education and women's IPV experience. Moreover, the relationship between women's age at marriage and their IPV experiences was fully mediated by their decision-making ability, highlighting the importance of empowerment in decision-making. These findings underscore the need for targeted interventions that address the interconnected factors affecting IPV risk among married women in Sri Lanka, particularly focusing on education, empowerment, and marriage timing.

"Treat people with human dignity": the perspective of older adults on the quality of geriatric rehabilitation.

The aim of this study was to gain insight into the perspectives of older adults on the quality of geriatric rehabilitation (GR) during the trajectory of GR from admission until six weeks after discharge. We conducted a longitudinal qualitative study. Participants were interviewed three times: at the start of rehabilitation, at discharge, and six weeks after discharge. The data were analysed using a thematic analysis. In total, 50 interviews were conducted, with 18 participants being interviewed multiple times. The following themes emerged: 1. A bond of trust with health care professionals (HCPs), 2. Being prepared and informed at all stages of GR, 3. Participants emphasise physical and occupational therapy rather than other aspects of care as comprising GR 4. Changing needs regarding (the extent of) involvement in decision-making, 5. Contact with family and peers. For older adults, preparation for and good organisation of rehabilitation and social interaction with HCPs and other older adults were found to be important for the perceived quality of GR. Social interaction is influenced by how HCPs engage with older adults in all the phases of the rehabilitation process. Older adults have varying preferences about involvement in decision-making during GR. These perspectives should be acknowledged and acted upon in clinical practice to further improve the quality of care in GR.

Exploring Patients' Perceptions of One-step Surgery for Primary Cutaneous Melanoma: A Qualitative Study.

High-frequency ultrasonography (> 20 MHz) has allowed for preoperative measurement of melanoma thickness and thus a one-step surgery strategy. The potential benefits of one-step surgery to patients remain unexplored. From June 2022 to August 2023, 2 dermatologists conducted semi-structured individual interviews with patients who had undergone HFUS examination allowing the choice for one-step surgery (group A) and with patients who had had standard two-step surgery (group B). Analysis of interviews with 21 patients (age range 31-81 years) revealed 5 main themes: (a) understanding the diagnosis, highlighting the significance of clear and comprehensive medical explanations; (b) personal factors considered in treatment decisions, including preferences for minimizing surgical procedures; (c) making choices, bearing responsibility, thus showcasing different levels of patient involvement in decision-making; (d) high- frequency ultrasonography reassurance emphasizing the role of medical reassurance, and (e) patient satisfaction, discussing surgical outcomes and the decision-making process. The majority of participants expressed a clear preference for one-step surgery, perceived as a pragmatic and fast surgical strategy while minimizing interventions. In conclusion, the results emphasize the importance of patient-centred care. These insights can guide improved preoperative consultations and enhance shared decision-making between healthcare professionals and patients regarding melanoma treatment strategies.

“In an ideal world”: A qualitative exploration of shared decision-making and weight stigma in antenatal care

BackgroundShared decision-making supports women’s autonomy in antenatal care, but several barriers to shared decision-making have been identified in practice. Women with high body mass index experience a higher rate of interventions, which could provide more opportunities for shared decision-making in antenatal care. However, weight stigma may exist as a barrier to shared decision-making, limiting access to collaborative care. AimTo explore how shared decision-making is implemented and whether body mass index influences maternity clinicians' use of shared decision-making when providing antenatal care for women. MethodsMaternity clinicians were recruited via purposive sampling from two sites in metropolitan Melbourne, Australia. Semi-structured interviews were audio recorded, transcribed, and analysed using reflexive thematic analysis. FindingsTwelve maternity clinicians consented to participate. Three themes and ten sub-themes were identified. The themes were: 1) Whose choice is it anyway? 2) Pregnancy as risky 3) Excess weight as a diseased state. DiscussionMaternity clinicians in this study view pregnancy through a risk management lens that complicates women’s involvement in decision-making, demonstrating inherent beliefs that may further limit options for women with high body mass index. ConclusionShared decision-making is difficult to implement in the current antenatal clinic setting and requires significant structural consideration to become a reality for women. Clinicians may inadvertently limit meaningful opportunities to engage in shared decision-making with women with high body mass index due to preconceived perceptions of risk and stigmatising beliefs about women with high body mass index.

Parental Preferences and Shared Decision-Making for the Management of Febrile Young Infants.

To inform shared decision-making by identifying parental preferences for the management of their febrile young infant. This was a sequential explanatory mixed-methods study using a cross-sectional questionnaire (May 2020-May 2022) followed by qualitative focus groups (September-December 2022) with parents of infants aged ≤60 days evaluated for fever at a tertiary pediatric hospital. Parental expectations, stressors, and desired level of decisional involvement were assessed using multiple-choice and 6-point-Likert scales. Questionnaire results informed the qualitative naturalistic inquiry into parents' decision-making experiences and preferences regarding the need for lumbar puncture (LP) and hospitalization. Among 432 parents (64.9% response), few anticipated the need for LP (10.2%) or hospitalization (20.8%), and these were selected as the most stressful aspects of management. No parent identified lack of decisional involvement as the most important stressor, although nearly all (97.5%) wanted to be involved in management decisions. Six focus groups with a subset of 17 parents revealed 4 main themes: (1) varying preferences for decisional involvement depending on the strength of the medical recommendation; (2) importance of involving parents in their infant's medical care; (3) need for tailored information; and (4) importance of supportive relationships. Parents reported feeling involved in discussions about their infant's care but that decisions regarding LP and hospitalization were usually made by the medical team. Parents of febrile young infants identified LP and hospitalization as the most unexpected and stressful aspects of care. Understanding individual family expectations and tailoring information based on the strength of medical recommendation is necessary to guide shared decision-making.

Public’s Visual Preferences Survey Facilitates Community-Based Design and Color Standards Creation

According to research, there is a disparity in the aesthetic design preferences of the public and architects. This is especially noticeable in urban areas environments, where there is a wide range of demographic variables and a lack of active public involvement in decision-making. The study included a visual preference survey to evaluate the perception and ranking of two dominant color schemes in local development projects in Stockholm across different age, ethnicity, and gender groups from Sweden. Over 400 people participated in the survey, which used photo-elicitation and a literature review. The objective was to determine the extent of divergence and disparities in the ranking of color schemes. The first dominant color schemes are a group of four analogous colors related to the Natural Color System’s (NSC’s) basic colors. The second is a group of four neutral colors that are related to grayscale colors. The study demonstrates that one could also measure building color schemes using visual preference ranking. Moreover, the research introduced a unique method for city planners to understand diverse ethnic, gender, and age group perceptions of color schemes in current projects, promoting active participation in decision-making and providing valuable insights. These insights can enhance people’s sense of belonging, a prerequisite for social sustainability, and improve the quality and profitability of future projects.

Midwife-led quality improvement: Increasing the use of evidence-based birth practices in Uganda

BackgroundAddressing the evidence-to-practice gap in midwifery is vital for improving maternal and newborn health outcomes. Despite the potential of involving midwives in quality improvement interventions to address this gap, such interventions are understudied. In a Ugandan urban hospital, midwifery practices with a significant evidence-to-practice gap have been identified as areas for clinical improvement. ObjectivesThe primary objective of the Quality Improvement was to increase the uptake of identified and essential midwifery practices through a quality improvement approach led by midwives. ParticipantsWe enrolled 703 women aged 18 years and older with uncomplicated full-term pregnancies (between 37+0 and 42+0 weeks) who gave birth at the facility. InterventionThe intervention focused on evidence-based practices with an identified evidence-to-practice gap: dynamic birth position, including women's involvement in birth position decision-making, perineal protection and intrapartum support. A team of midwives led a seven-month co-created quality improvement intervention. The intervention used Plan–Do–Study–Act (PDSA) cycles, following the Model for Improvement and included a train-the-trainer approach and weekly online support meetings. Data collectionIn this single-case prospective observational study, we compared pre-, during and post-intervention uptake of evidence-based practices. Trained research assistants collected data through interviews and observations. ResultsWe observed improvements in the uptake of all clinical improvement areas. Dynamic birth positions increased from 0 % to 79 %, decision-making of birth positions from 0 % to 75 %, perineal protection measures from 62 % to 92 % and intrapartum support from 7 % to 67 %. ConclusionA multifactorial midwife-led Quality Improvement resulted in significant and sustained improvements in the uptake of evidence-based practices in maternal and newborn healthcare. If given the mandate and time, midwives can successfully lead Quality Improvements, which enhance the quality of care and close the evidence-to-practice gaps in maternal and newborn health. The study's results underscore the significance of developing effective strategies to enhance care quality and promote the adoption of evidence-based midwifery practices.

Towards Establishing Quality Standards on Human Rights for Services in Dementia Care.

People with dementia often experience violations of fundamental human rights and impeded access to healthcare. This study aims to investigate the views of experts regarding the use of the United Nations Convention on the Rights of People with Disabilities (CRPD) principles as quality standards for human rights-based care. A single-round Delphi e-consultation with 15 dementia experts was designed to evaluate each CRPD principle and collect feedback on their views about the application of the CRPD principles in dementia care. The CRPD principles were fully endorsed as quality standards; however, several experts commented on the complexities of the use of CRPD principles in relation to information disclosure, capacity assessment, stakeholders' involvement in decision-making, respecting needs and preferences, holistic approaches in care practice, and protection against abuse, neglect and discrimination. These findings indicate the CRPD quality standards were fully applicable for people with dementia although some clarification around interpretation could assist in their use. Future research should elaborate on further points of support and guidance for dementia care providing examples of good practice from across the globe, and develop a concordant, human rights-based scheme for the implementation and evaluation of dementia services. This study suggests that the CRPD can serve as a benchmark for human rights-based practices in dementia services globally that could enhance nursing care practice. Nursing staff are encouraged to consider human rights in relation to the complexities associated with people with dementia, their caregivers, and other services involved in their care.

Nurses' Experiences of the Prerequisites for Implementing Family-Centered Care to Prevent Pediatric Delirium.

The aim of this study was to describe nurses' experiences of the prerequisites for implementing family-centered care to prevent pediatric delirium. The research employed a qualitative, descriptive study design. A total of 10 nurses working in the pediatric intensive care unit at 1 university hospital participated in the study. The quality data were collected using individual semistructured interviews, and the data were then analyzed by inductive content analysis. The prerequisites for implementing family-centered care to prevent delirium among pediatric patients consisted of 30 subcategories that were grouped into 11 generic categories. The generic categories were further grouped into 5 main categories: (1) an environment that supports family presence, (2) psychosocial support for the family, (3) individual family involvement, (4) family participation in shared decision-making, and (5) nurses' professional competence. According to the nurses' experiences, the implementation of a family-centered approach to preventing delirium in pediatric patients requires creating a supportive environment for families, providing psychosocial support, encouraging family involvement in decision-making, and ensuring that all nurses have the necessary skills.