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

BMC Geriatrics

Research

Da Eun Kim¹  Min Jung Kim² 

[1] College of Nursing and Research Institute of Nursing Science, Kyungpook National University, Daegu, Republic of Korea;Department of Nursing, Kyongbuk Science College, Gyeongsangbuk-do, Republic of Korea;

关键词: Shared decision-making;    Person-centered care;    Long-term care;    Aged;   

DOI  :  10.1186/s12877-023-04301-6

 received in 2023-06-10, accepted in 2023-09-08,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundShared 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.MethodsA 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.ResultsThe 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).ConclusionsThis 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.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

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Fig. 4