Experiences of shared decision making in acute hospitals: A mixed methods secondary analysis of the Irish National Inpatient Experience Survey

Abstract

IntroductionThis study explored patient experiences of shared decision making (SDM) in public acute hospitals in Ireland. MethodsQuantitative and qualitative data from three years of the Irish National Inpatient Experience Survey were analysed. Survey questions were mapped to definitions of SDM and subjected to principal components analysis. Three SDM subscales (care on the ward; treatments; discharge) and one overall SDM scale were created. Differences in experiences of SDM by aspects of care and patient group were assessed. Thematic analysis of qualitative responses was undertaken. Results39,453 patients participated in the survey. The mean SDM experience score was 7.60 ± 2.43. Experience scores were highest on the treatments sub-scale, and lowest during discharge. Patients who had a non-emergency admission, those aged 51–80 years and men had more positive experiences than other groups. Patient comments highlighted that opportunities to clarify information and facilitation of families/caregivers in SDM were found to be lacking. ConclusionThere were differences in experiences of SDM by aspects of care and patient group. Practice implicationsEfforts to improve SDM in acute hospitals are required, particularly at the time of discharge. SDM may be improved by facilitation of more time for discussion between clinicians and patients and/or their families/caregivers.