Patient Participation in Decision-Making During Nursing Care: A Relational Autonomy Perspective.
Yin Wang, Lissette Avilés, Colin Chandler
PMID 40974071WHAT IT FOUND
In Chinese inpatient nursing, patients sometimes collaborated, deferred to nurses or family, or acted alone; nurses sometimes persuaded or excluded them.
Participation depended on risk, trust and family roles.
Key findings
01The study found two broad decision-making patterns in nursing care: co-determination and unilateral determination.
02Nurses were more willing to collaborate in low-risk decisions, while higher-risk decisions reduced space for negotiation.
03Patients sometimes relied on nurses or family, and admission decisions could occur mainly between nurses and family without direct patient involvement.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
It was done in a neurology ward in a Chinese public hospital during the pandemic, so it may not transfer to other settings. It included only patients with cerebrovascular and cardiovascular diseases, and diabetes, not all chronic conditions. Patients had to be stable enough and stay at least 3 days, so patients outside those criteria were not captured. Transcripts and findings were not returned to participants for verification.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read family involvement as automatically meaning the patient participated. Some patients were not told what was happening because nurses and family made decisions without them.