Shared decision making----A concept analysis

Abstract

Purpose The purpose of this study was to analyze the concept of shared decision making being used in Europe and America, and examine the possible applicability that concept to women's reproductive health in the practice of mid-wifery. Methods Rodgers' (2000) approach to concept analysis was used to review literature focused on the areas of nursing and psychosociology, and the contents were qualitatively analyzed for attributes, antecedents, and consequences. Results The attributes of shared decision making were found to be 1) that the patient is involved and 2) that it is a dy-namic decision process where persons involved mutually influence one another. This process acts as an agency of communication and interaction. Through numerous two-way communica-tions, persons involved share information gathered concerning choices available, the current situation, outlook, goals, values, preferences, and ideas. Working together they move toward a desirable decision and come to agree-ment. The antecedents were 1) a change in health concept-variation in disease structure and response system charac-teristics, 2) medical uncertainties and advances in scientific technologies, 3) the certainty of a paradigm shift in the medical model, 4) characteristics of those involved, including the patient, and perception of authority. The consequences were 1) maximizing people's health and QOL, 2) psychological changes and growth in the patient, 3) patient satisfaction with decisions, and 4) the practice of ethical clinical care, including the use of appro-priate scientific technology. Conclusion The concept of shared decision making is being widely introduced in the field as a care methodology, and the possibility of it being further developed is anticipated as the body of experiences grows. This concept provides con-crete support to women-centered care and research by placing women at the center of the decision-making while at the same time sharing the process. This concept can be applied when providing continual support.