Clinical decision-making: predictors of patient participation in  nursing care.
OBJECTIVE
To investigate predictors of patients' preferences for participation in clinical decision-making in inpatient nursing care.


BACKGROUND
Patient participation in decision-making in nursing care is regarded as a prerequisite for good clinical practice regarding the person's autonomy and integrity.


METHODS
A cross-sectional survey of 428 persons, newly discharged from inpatient care.


METHODS
The survey was conducted using the Control Preference Scale. Multiple logistic regression analysis was used for testing the association of patient characteristics with preferences for participation.


RESULTS
Patients, in general, preferred adopting a passive role. However, predictors for adopting an active participatory role were the patient's gender (odds ratio = 1.8), education (odds ratio = 2.2), living condition (odds ratio = 1.8) and occupational status (odds ratio = 2.0). A probability of 53% was estimated, which female senior citizens with at least a high school degree and who lived alone would prefer an active role in clinical decision-making. At the same time, a working cohabiting male with less than a high school degree had a probability of 8% for active participation in clinical decision making in nursing care.


CONCLUSIONS
Patient preferences for participation differed considerably and are best elicited by assessment of the individual patient. Relevance to clinical practice. The nurses have a professional responsibility to act in such a way that patients can participate and make decisions according to their own values from an informed position. Access to knowledge of patients'basic assumptions and preferences for participation is of great value for nurses in the care process. There is a need for nurses to use structured methods and tools for eliciting individual patient preferences regarding participation in clinical decision-making.
Florin
Jan
J
Department of Health and Social Sciences, Högskolan Dalarna, Falun, Sweden. jfl@du.se
Ehrenberg
Anna
A
Ehnfors
Margareta
M
D005260:Female; D006801:Humans; D008297:Male; D009723:Nurse-Patient Relations; D009729:Nursing; D010358:Patient Participation; D010818:Practice Patterns, Physicians'