Patients' preferences for involvement in clinical decision-making within secondary care and the factors that influence their preferences

J Nurs Manag. 2005 Mar;13(2):119-27. doi: 10.1111/j.1365-2934.2004.00498.x.


The research aimed to identify what involvement patients want in clinical decision-making and explore the underlying factors influencing that choice, thus identifying aids and barriers to increasing patients' involvement in decision-making. The study design was inspired by interpretative phenomenology, thus the framework for analysis is intended to aid interpretation and comprehension of the patients' experiences and understanding through identifying similarities and differences in their stories. Data were collected through semi-structured interviews of twenty people who were patients in a secondary care milieu at the time of interview. Results showed that, 20% of patients chose an active role in decision-making and 80% chose a collaborative or a passive role. However what people selected on the autonomy preference index was not always reflected in the interview. Additionally, the findings suggest that the NHS maintains a paternalistic approach. Lack of staff, lack of information and poor continuity of care with nursing staff made patients feel disempowered.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Clinical Competence
  • Decision Making*
  • England
  • Female
  • Hospitals, Public
  • Humans
  • Inpatients / psychology*
  • Interviews as Topic
  • Male
  • Middle Aged
  • Patient Participation / psychology*
  • Patient Satisfaction / statistics & numerical data*
  • Patient-Centered Care / statistics & numerical data*
  • Personal Autonomy
  • Power, Psychological
  • Qualitative Research
  • Surveys and Questionnaires