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Patient Decision-making Behavior

An Emerging Paradigm for Nursing Science

Pierce, Penny F.; Hicks, Frank D.


Background As healthcare technology and medical therapies proliferate, healthcare providers have more options to offer and patients have more options from which to choose. Active patient participation in healthcare decision making is a relatively new phenomenon that has been born of sociocultural, ethical, and legal influences. Patients, however, often find healthcare decisions bewildering, stressful, and anxiety-provoking.

Objectives The purpose of this review is to provide a framework for those interested in pursuing patient decision-making investigations and suggest ways in which current knowledge can be extended to develop a scientific platform upon which to build decision support interventions.

Method Literature review.

Discussion This review (a) provides a context for understanding patient decision making; (b) explicates the state of the science of patient decision making; (c) identifies significant theoretical, methodological, and measurement issues; and, (d) identifies gaps in patient decision-making knowledge and propose areas for further investigation.

Penny F. Pierce, PhD, RN, is Associate Professor, School of Nursing, University of Michigan, Ann Arbor.

Frank D. Hicks, PhD, RN, is Assistant Professor, Medical-Surgical Nursing, Niehoff School of Nursing, Loyola University Chicago, and Postdoctoral Fellow, School of Nursing, University of Michigan, Ann Arbor.

Accepted for publication June 13, 2001.

Address reprint requests to Penny F. Pierce, PhD, RN, 400 North Ingalls, School of Nursing, University of Michigan, Ann Arbor, MI 48109-0482.

© 2001 Lippincott Williams & Wilkins, Inc.