Healthcare providers’ cognitive perception and experience of shared decision-making of nurse-led weaning of patients on invasive mechanical ventilation:a qualitative study

Background The clinical implementation of the nurse-led shared decision-making model for weaning patients from invasive mechanical ventilation has shown significant advantages. However, some issues have been revealed, and there has not yet been in-depth research on the understanding and experiences of healthcare personnel regarding this decision-making approach. Objective To clarify healthcare professionals' perspectives on the shared decision-making model for nurse-led weaning of patients on invasive mechanical ventilation and to determine improvement measures to promote the routine implementation of the model. Methods An interview outline was developed based on the SWOT model. Using purposive sampling, seven physicians, sixteen nurses, and seven respiratory therapists working in the intensive care unit of Shanghai Tenth People's Hospital from June to August 2025 were selected for semi-structured interviews,and content analysis method was used for data analysis. Results Four themes were extracted for internal advantages: alleviating the pressure on doctors in diagnosis and decision-making; clinical nurses' capability and willingness to implement; improving the success rate of weaning critically ill patients; and enhancing recognition among patients, families, and surgeons, thereby increasing the department's patient loyalty. Four themes were extracted for internal weaknesses:increased work pressure; lack of decision-support tools; smoothness of implementation processes; and ineffective human resource allocation mechanisms; and insufficient information technology. The external opportunities identified two themes: support from departmental policies and culture; and a solid evidence base. The external threats encompassed three themes: poor communication between medical staff; cognitive differences among healthcare personnel regarding weaning; and insufficient confidence in nurses taking the lead. Conclusion The nurse-led shared decision-making for weaning patients off invasive mechanical ventilation has certain advantages. In the future, it should leverage existing opportunities, mitigate internal weaknesses, acknowledge external threats, and develop a standardized nurse-led shared decision-making model for weaning patients off invasive mechanical ventilation to promote the best evidence-based practices in this area. Clinical Trial Number Not applicable.This research is a qualitative study.