The mediating and moderating effects of shared decision making and medical autonomy on improving medical service satisfaction in
emergency observation units.
Int Emerg Nurs 2021;
60:101101. [PMID:
34864441 DOI:
10.1016/j.ienj.2021.101101]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 09/15/2021] [Accepted: 09/29/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVE
Distinct from other medical settings, the emergency setting is unique and requires flexible and adaptive decision making to provide quality medical services. This study was designed to investigate the mediating and moderating effects of shared decision making (SDM) and patient attitude toward medical autonomy (AMA) on improving medical service satisfaction (MSS) in emergency observation units.
METHODS
In this cross-sectional study, we collected data via a verified structured questionnaire. A total of 165 participants met the inclusion criteria, and 100% of the questionnaires recovered were valid.
RESULTS
The results show that SDM had a partial mediating effect (p < 0.01) and that it significantly improved MSS. AMA had a moderating effect on some domains (p < 0.01). Meeting patient needs and increasing their participation in decision making can effectively improve MSS. However, excessive patient participation might not be productive, which is an important finding of this study.
CONCLUSION
In emergency observation units, SDM-based doctor-patient interactions and cooperation, effective patient-centered communication, and respect for patients' medical autonomy improve the doctor-patient relationship and patients' health literacy. Patients can thus participate in selecting the best treatment plan to achieve expected health outcomes, and ultimately improve MSS.
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