Shared Decision-Making in the Context of African, Caribbean, and Black Patients Seeking Diabetes Care: A Concept Analysis with Implications for Cardiovascular Advanced Practice Nursing

Background: Shared decision-making (SDM) enhances patient-clinician collaboration. Racism and discrimination hinder SDM for African, Caribbean, and Black (ACB) patients, who are disproportionately affected by diabetes and cardiovascular complications. There is limited evidence investigating SDM for ACB patients with diabetes and no concept analyses to date have conceptualized SDM for ACB patients with diabetes. Purpose: To clarify the concept of SDM among ACB patients with diabetes. Methods: Following Walker and Avant’s concept analysis approach, we searched CINAHL, Nursing & Allied Health, Medline, Scopus, and Embase in November 2023. Eligible articles defined SDM, involved ACB patients, and were published after 2010. Results: Of 181 records, 11 studies were included. Identified attributes include collaboration, communication, and cultural competency. Shared decision-making is conceptualized with a focus on the barriers impeding this approach. Conclusions: Equitable SDM improves ACB patients’ involvement in decisions. Cardiovascular Advanced Practice Nurses have an important role in implementing equitable SDM. Research should focus on supporting all members of the interprofessional team to mitigate barriers to SDM.