Research progress of patients′decision self-efficacy in treatment decision-making / 中国实用护理杂志

Patients′ decision self-efficacy in treatment decision-making refers to the patient′s level of confidence in their ability to make medical decisions, which can affect the patient′s confidence and readiness to participate in their treatment or care decision-making, and it is a key facilitator for patients as collaborators working with health care providers to make high-quality treatment and care decisions. In order to comprehensively understand the research progress of patients′ self-efficacy of treatmentdecision-making, this paper reviews the connotation, assessment tools, status quo, influencing factors and intervention strategies of patients′ decision self-efficacy of treatment decision-making, providing the basis for objectively evaluating patients′ decision self-efficacy of treatment decisions in the future and the development of related research.

Patient Decision Control and the Use of Cardiac Catheterization.

BACKGROUND: Shared decision-making is a key determinant of patient-centered care. A lack of patient involvement in treatment decisions may explain persistent racial disparities in rates of cardiac catheterization (CCATH). To date, limited evidence exists to demonstrate whether patients who engage in shared decision-makingare more or less likely to undergo non-emergency CCATH. OBJECTIVE: To assess the relationship between participation in the decision to undergo a CCATH and the use of CCATH. We also examined whether preference for or actual engagement in decision-making varied by patient race. METHODS: We analyzed data from 826 male Veterans Administration patients for whom CCATH was indicated and who participated in the Cardiac Decision Making Study. RESULTS: After controlling for confounders, patients reporting any degree of decision control were more likely to receive CCATH compared with those reporting no control (doctor made decision without patient input) (54% vs 39%, P<.0001). Across racial groups, patients were equally likely to report a preference for control over decision-making (P=.53) as well as to experience discordance between their preference for control and their perception of the actual decision-making process (P=.59). Therefore, these factors did not mediate racial disparities in rates of CCATH use. CONCLUSION: Shared decision-making is an essential feature of whole-person care. While participation in decision-making may not explain disparities in CCATH rates, further work is required to identify strategies to improve congruence between patients' desire for and actual control over decision-making to actualize patient-centered care.