Factors influencing shared decision-making in long-term care facilities

Abstract

Background Shared decision-making, a communicative process to reach decisions based on informed preferences, evidence, and co-created goals, improves care satisfaction and patients’ quality of life. However, shared decision-making has not been widely implemented in long-term care facilities, and few studies have examined how to promote the shared decision-making practice. This study aimed to identify the influencing factors of shared decision-making based on the Person-centered Practice Framework in long-term care facilities. Methods A total of 300 staff (nursing staff, social workers, and personal care workers) in 13 Korean long-term care facilities participated in this study. Data from 280 respondents were finally analyzed, excluding respondents with missing values. Data were collected using structured questionnaires that included items on shared decision-making, personal factors (e.g., knowledge about dementia, person-centered care education, person-centered attitude, communication behavior, and job tenure), and care environment factors (e.g., person-centered climate, staffing level, effective staff relationships, supportive supervisors, and power-sharing). Multilevel linear regression analyses were performed using Mplus Version 8.8. Results The mean shared decision-making score was 35.78 (range 8–45). Staff with experience of person-centered care education (β = 0.198, p = 0.034), a higher person-centered attitude score (β = 0.201, p = 0.007), and a higher communication behavior score (β = 0.242, p < 0.001) were more likely to report a higher shared decision-making score. In addition, staff who viewed their care environment as more person-centered were more likely to report a higher shared decision-making score (β = 0.416, p < 0.001). Conclusions This study highlights that personal (e.g., person-centered care education, person-centered attitude, and communication behavior) and care environment (e.g., person-centered climate) factors could influence shared decision-making for long-term care residents. These findings could be foundational evidence for facilitating shared decision-making practice in long-term care settings.

Barriers and Stimulus in Shared Decision Making Among Aesthetic Dermatologists in China: Findings from a Cross-Sectional Study

“…The aim of medical aesthetic intervention is to enhance an individual's overall appearance and well-being, with procedures typically driven by the patient's desires rather than medical necessity, and the subjective nature of beauty standards, potential psychological implications of aesthetic procedures, and ethical considerations could also influence the decision-making dynamics, all of which demonstrates the significant value of SDM for the selection of treatment options in medical aesthetics. [9][10][11] However, evidence demonstrating whether SDM is universally applied or not is not yet understood and studied in China. 12,13 Previous studies indicated that Chinese physicians perceived SDM with high willingness (78.38%) based on the discrete-choice experiment (DCE) survey and the SDM questionnaire physician version (SDM-Q-Doc) survey.…”