The Concept of Decisional Control: Building the Base for Evidence‐Based Nursing Practice

Abstract

Future research needs to focus on the identification of the differences in decisional control by country, in differing cultural and ethnic groups within countries, and in various geographical areas of countries. The relationship of patient characteristics (e.g., age, gender, education, and income) to decisional control preferences is not clearly identified. A large gap in the research relates to how nurses can facilitate preferred decisional control to improve patient outcomes through evidence-based nursing practice.

Patients’ decisional control over care: a cross‐national comparison from both the patients’ and nurses’ points of view

“… who found that patients held different views of preferred level of participation and that nurses failed to assess individual patient preferences, paying lip service to patient preferences but not actually involving the patients in decision‐making according to the patient's own perceptions. In this sense, decisional control refers to a hypothetical power struggle where healthcare providers in their traditional roles may believe that they know what is best for patients and so seek to retain total decisional control . However, patients from differing backgrounds, having different resources and capabilities, should be capable of having an impact on participation, communication and decision‐making .…”

“…This scale included the assessment of knowledge delivery, the possibility to express wishes and opinions, plus having a say and participating in decision‐making with regards to daily nursing care. However, specific tools measuring decisional control have been created and could have been used together with the ICS‐B‐Decisional control. The ICS‐B‐Decisional control could also be further developed to focus on specific areas of care.…”

“…Decisional control as a concept is poorly defined in healthcare literature, but in general terms, it means the ability or power to decide what will be one's involvement in healthcare decisions and includes the encouragement of the patient to take on responsibilities and to take control by providing options to choose from and decide on . All definitions recognise client's individuality and need for individualised care that is tailored to suit the patient's preferences as an important aspect of patient participation in nursing care . Patients have decisional control over their care when the individual has expectations of having the power to participate in making decisions to obtain desirable consequences .…”

Participation of Very Old Adults in Health Care Decisions

“…The distinction between exhibited participation and preference is important because some people may not have the appropriate information, skills, or support to feel they can participate in a knowledgeable way. 21,[36][37][38][39][40][41] The self-perception of inadequate skills may lead to a stated preference for lower participation in decision making. 19 Another study has taken a similar approach to distinguish preference from behavior in elderly adults.…”

Decisional control preferences among patients with advanced cancer: An international multicenter cross-sectional survey

“…Decisional control is defined as “an individual’s expectation of having the power to participate in decisions in order to obtain desirable consequences.” 1 Understanding decisional control preferences of patients with advanced cancer regarding cancer care is important as it improves patient–clinician communication, quality cancer care, and patient satisfaction and reduces cost of care. 2–8 Prior studies suggest better patient satisfaction and quality cancer care outcomes when the decisions are patient-centered and shared.…”