Patient Involvement in Shared Decision-Making: Do Patients Rate Physicians and Nurses Differently?

Maura Galletta (), Maria Francesca Piazza, Stefania Luisa Meloni, Elsa Chessa, Ilenia Piras, Judith E. Arnetz and Ernesto D’Aloja
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Maura Galletta: Department of Medical Sciences and Public Health, University of Cagliari, 09100 Cagliari, Italy
Maria Francesca Piazza: Liguria Health Authority (A.Li.Sa.), 16121 Genoa, Italy
Stefania Luisa Meloni: Department of Medical Sciences and Public Health, University of Cagliari, 09100 Cagliari, Italy
Elsa Chessa: Intensive Care Unit, Binaghi Hospital, ASL Cagliari, 09100 Cagliari, Italy
Ilenia Piras: Emergency Department, SS. Trinità Hospital, ASL Cagliari, 09100 Cagliari, Italy
Judith E. Arnetz: Department of Family Medicine, Michigan State University, Grand Rapids, MI 48824, USA
Ernesto D’Aloja: Department of Medical Sciences and Public Health, University of Cagliari, 09100 Cagliari, Italy

IJERPH, 2022, vol. 19, issue 21, 1-13

Abstract: Background. Shared decision-making implies that patients and healthcare professionals make decisions together about clinical exams, available treatments, choice of options, and the benefit or downside of every choice. Patients involved in the shared decision-making process are more compliant with treatments and have a reduced risk of complications related to the pathology. In Italy, patient involvement in caring processes is still barely investigated. Aim. To investigate patients’ perceptions about shared decision-making with physicians and nurses, respectively, and to examine the relationship between shared decision-making and patient satisfaction and perceived quality of care/treatment. Methods. The study was performed between March and June 2019 in two wards of one Italian hospital. A questionnaire was administered to inpatients at the time of admission and again at discharge, including demographic information and measurement scales regarding patient involvement in shared decision-making, patient satisfaction, and perceived quality of treatment/care. Results. A total of 151 out of 301 patients completed questionnaires at both admission and discharge. Patients’ scores for shared decision-making (information, patient needs, treatment planning) were significantly different for physicians and nurses. At both admission and discharge, patients rated shared decision-making significantly higher for physicians compared to nurses, while there were no differences in their satisfaction ratings. Patient ratings of physicians did not change from admission (information: mean (M) = 3.50, standard deviation (SD) = 0.81; patient need: M = 3.05, SD = 1.05; treatment planning: M = 2.75, SD = 1.23) to discharge (information: M = 3.50, SD = 0.79; patient need: M = 3.17, SD = 1.02; treatment planning: M = 2.66, SD = 1.23) ( p = 0.924, p = 0.098, p = 0.293, respectively), but patients’ ratings of nurses’ behavior increased significantly from admission (information: M = 2.44, SD = 1.23; patient need: M = 2.27, SD = 1.17; treatment planning: M = 2.12, SD = 1.19) to discharge (information: M = 2.62, SD = 1.22; patient need: M = 2.53, SD = 1.24; treatment planning: M = 2.35, SD = 1.21) ( p = 0.019, p = 0.001, p = 0.003, respectively). Attention to patients’ needs was the key determinant of both satisfaction with nurses (OR = 3.65, 95% CI = 1.31–10.14, p = 0.013) and perceived quality of care (OR = 3.97, 95% CI = 1.49–10.55, p = 0.006). Providing appropriate information about disease progress and treatments was a key determinant of both satisfaction with physicians (OR = 19.75, 95% CI = 7.29–53.55, p < 0.001) and perceived quality of treatment (OR = 8.03, 95% CI = 3.25–19.81, p < 0.001). Discussion. Nurses should be sensitized to involving patients in the decision-making process, especially upon hospital admission. Specific training about effective communication techniques can be implemented to manage relationships with patients in different caring situations. Practical implications and future directions are discussed.

Keywords: shared decision-making; nurses; physicians; patient involvement; patient satisfaction; perceived quality of care (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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