Health Care Professional Factors Influencing Shared Medical Decision Making in Korea

Abstract

Till date, the medical decision-making process in Korea has followed the paternalist model, relying on the instructions of physicians. However, in recent years, shared decision making at the end-of-life between physicians and nurses is now emphasized in Korea. The purpose of this study was conducted to explore how health care professionals' characteristics, attitude toward dignified dying, and moral sensitivity affect their shared medical decision making. The design was descriptive survey. This study was undertaken in two university hospitals in two metropolitan cities, South Korea. The participants were 344 nurses and 80 physicians who work at university hospitals selected by convenience sampling method. Data were collected from January 10 through March 20, 2014 using the Dignified Dying Scale, Moral Sensitivity Scale, and Shared Medical Decision-Making Scale. Shared medical decision making, attitude toward dignified dying, moral sensitivity, age, and working experience had a significant correlation with each other. The factors affecting shared medical decision making of Korean health care professionals were moral sensitivity and attitude toward dignified dying. These variables explained 22.4% of the shared medical decision making. Moral sensitivity and a positive attitude toward dignified dying should be promoted among health care professionals as a part of an educational program for shared medical decision making.

Awareness of Doctors’ Shared Decision-Making in Life-Sustaining Care Decisions

“…In another study, Jo et al [ 24 ] analyzed the effects of the characteristics of medical personnel on shared decision-making during end-of-life care. Age, work experience, moral sensitivity, and attitudes about dignified death were found to be associated with practicing shared decision-making.…”

Shared decision making in a semi-secluded chronic psychiatric ward: The reflective lifeworld experiences of patients with schizophrenia or schizoaffective disorders and nursing staff

“…Existing models of SDM, are to a large extent, focused on medical decision-making processes involving pharmaceutical consultation and treatment options and the doctor-patient alliance (Beitinger, Kissling, & Hamann, 2014;Charles, Gafni, & Whelan, 1997;Elwyn et al, 2012), But, studies on SDM in nursing practice are increasing. It is known that nurses play an important complementary role in medical decision-making processes in lifeprolonging treatment by facilitating and checking the information is well understood by patients and significant others (Bos-van den Hoek et al, 2020;Matthias et al, 2014;Jo et al, 2015). The stepwise approach of facilitating SDM by nurses follows approximately the following sequence: 1) informing patients that a decision have to be made, 2) explaining options and associated benefits or disadvantages, 3) exploring the patients" preferences, and finally 4) the making or deferring the decision (Siggelbout et al, 2015).…”

Shared clinical decision-making experiences in nursing: A qualitative study

“…Shared decision making (SDM) is a patient-centred nursing concept that emphasises the autonomy of the patient. It is a co-operative process of exchanging information, communication and response, and treatment decisions made between medical staff and patients [1,2,3]. The SDM healthcare experiences of medical staff and mutual participation of patients has been part of the selection process for health care treatment in recent years.…”

“…Jo, An, and Lee [1] pointed out that SDM is a comprehensive concept based on the values and autonomy of patients, family members, doctors and nursing staff, sharing information on treatment options, and decision methods. Nursing staff account for the majority of the professional medical care team and are the key members.…”