A b s t r a c t Objective:While preference elicitation techniques have been effective in helping patients make decisions consistent with their preferences, little is known about whether information about patient preferences affects clinicians in clinical decision making and improves patient outcomes. The purpose of this study was to evaluate a decision support system for eliciting elderly patients' preferences for self-care capability and providing this information to nurses in clinical practice-specifically, its effect on nurses' care priorities and the patient outcomes of preference achievement and patient satisfaction.Design: Three-group quasi-experimental design with one experimental and two control groups (N = 151). In the experimental group computer-processed information about individual patient's preferences was placed in patients' charts to be used for care planning.Results: Information about patient preferences changed nurses' care priorities to be more consistent with patient preferences and improved patients' preference achievement and physical functioning. Further, higher consistency between patient preferences and nurses' care priorities was associated with higher preference achievement, and higher preference achievement with greater patient satisfaction.
Conclusion:This study demonstrated that decision support for eliciting patient preferences and including them in nursing care planning is an effective and feasible strategy for improving nursing care and patient outcomes. 1,2 Studies of preferences for treatment of patients and health care professionals found that patient preferences are generally hard to predict.3-5 Also, it has been demonstrated that clinical outcomes perceived as excellent by health care professionals are not necessarily experienced in the same way by patients. 6,7 Recent literature has focused on the importance of including patient preferences in decisions regarding their care. 1,8,9 Also, there is increased emphasis on shared decision making between health care providers and patients, and on their working collaboratively to select the best care decisions.1,10 This research emphasizes that judgments about the right care decisions
305from the perspective of patients cannot be made without including patients' own perspectives about their perceived health care needs and preferences for health outcomes. Thus, a critical component for providing patient-centered care is to systematically elicit patients' perspectives of their health problems and preferences for outcomes, and include patient preferences in patient care to increase congruence between preferences and outcomes. This paper presents a study that tested the effect of eliciting elderly patients' preferences for self-care capability and providing this information to nurses in clinical practice on nurses' care priorities and the patient outcomes of preference achievement and patient satisfaction.