title: The emergency patient's participation in medical decision-making.
abstract: OBJECTIVE
  The purpose of this research was to explore the medical decision-making processes of patients in emergency departments.
  
  
  BACKGROUND
  Studies indicate that patients should be given enough time to acquire relevant information and receive adequate support when they need to make medical decisions. It is difficult to satisfy these requirements in emergency situations. Limited research has addressed the topic of decision-making among emergency patients.
  
  
  METHODS
  This qualitative study used a broadly defined grounded theory approach to explore decision-making in an emergency department in Taiwan.
  
  
  METHODS
  Thirty emergency patients were recruited between June and December 2011 for semi-structured interviews that were audio-taped and transcribed verbatim.
  
  
  RESULTS
  The study identified three stages in medical decision-making by emergency patients: predecision (interpreting the problem); decision (a balancing act) and postdecision (reclaiming the self). Transference was identified as the core category and pattern of behaviour through which patients resolved their main concerns. This transference around decision-making represents a type of bricolage.
  
  
  CONCLUSIONS
  The findings fill a gap in knowledge about the decision-making process among emergency patients.
  
  
  CONCLUSIONS
  The results inform emergency professionals seeking to support patients faced with complex medical decision-making and suggest an emphasis on informed patient decision-making, advocacy, patient-centred care and in-service education of health staff.
authors.affiliation: Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.|Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Li-Hsiang
authors.initials: LH
authors.lastname: Wang
authors.affiliation: Faculty of Nursing, University of Calgary, Calgary, AB, Canada.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Goopy
authors.affiliation: Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
authors.forename: Chun-Chih
authors.initials: CC
authors.lastname: Lin
authors.affiliation: Queensland University of Technology, Brisbane, Qld, Australia.
authors.forename: Alan
authors.initials: A
authors.lastname: Barnard
authors.affiliation: Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan. cyhan@gw.cgust.edu.tw.
authors.forename: Chin-Yen
authors.initials: CY
authors.lastname: Han
authors.affiliation: School of Nursing, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Hsueh-Erh
authors.initials: HE
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000066491:Clinical Decision-Making; D004630:Emergencies / Q000451:nursing*; D004636:Emergency Service, Hospital; D005260:Female; D066296:Grounded Theory; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D013624:Taiwan; D055815:Young Adult
keywords: bricolage; emergency nursing; grounded theory; patient participation in medical decision-making; transference