Comparison of Patient`s and Nurse`s Viewpoint on Shared Clinical Decision Making in Providing Nursing Care within Educational Hospitals, 2015

Abstract

Abstract: Background: The concept of shared clinical decision making is highly complex and central to the delivery of healthcare services and is being developed in nursing care delivery. Also it`s positive impact on health care outcomes is evident. However, there are few studies which compare the viewpoint of nurses and patients on this concept. This study was aimed to compare the patients and nurses viewpoint on shared clinical decision making in providing nursing care within educational hospitals in 2015.

Methods: In this descriptive correlational study, 151 nurses and 200 patients were recruited from 8 Medical Surgical wards of educational hospitals affiliated to Tabriz University of Medical Sciences. Data were collected by demographic questionnaire and shared clinical decision instrument which was developed by Kolovos. The instrument consisted of two scales, “Decision Making in Planning Nursing Care (12 items whit the score of 12-36) and “Decision Making in Implementing Nursing Care (11 items whit the score of 11-33).” In each scale, the perceived level of participation (extent and importance) was assessed on a three point scale. A lower score indicated greater patient participation in decision making or greater importance for such participation. Sampling was conducted in the form of quota available. Data analysis were performed by descriptive statistics including mean and standard deviation and inferential statistics including compare means. SPSS software (ver.21) is used for data analysis.

Results: The results showed that the mean scores of nurses and patients in term of collaboration and the importance of collaboration in shared decision making were at high level. The high score indicates low participation and importance. Moreover, there was a significant differences between nurse`s and patient`s viewpoints on three dimension of shared decision making including the importance of collaboration in care planning, the level, and importance of collaboration in care delivery (p<0.05). Discussion and conclusion: The collaboration of patients and nurses in shared clinical decision making is not in acceptable level. Moreover, patients put low emphasis on shared decision making in care planning as compared with nurses. Increasing the awareness of patients, nurses, and society in term of issue and also infrastructural reform could have a positive and significant impact on perception and facilitating the participation.