PATIENT-PERCEIVED SHARED DECISION-MAKING IN NURSE-DELIVERED PRE-ANAESTHESIA COUNSELLING: LEVELS, ITEM-LEVEL GAPS, AND SUBGROUP CONSISTENCY
Keywords:
Anesthesia; Decision Making, Shared; Patient Participation; Patient Preference; Perioperative Nursing; Preoperative CareAbstract
Aim: This study aimed to describe the level of patient-perceived shared decision-making after structured pre-anaesthesia counselling, identify the weakest steps of the process, and examine whether perceived shared decision-making differed across patient subgroups.
Methods: This is a secondary, descriptive analysis of post-intervention data from a single-group pretest–posttest quasi-experimental study in three tertiary care hospitals in Pakistan. One hundred adults scheduled for elective surgery and eligible for both general and regional anaesthesia received a 15–20-minute nurse-delivered counselling session. Perceived involvement was measured with the 9-item Shared Decision-Making Questionnaire and compared across gender, age, education, physical status, surgery type, and anaesthesia type.
Results: The questionnaire showed good reliability (α = .88). The mean score was 78.27 ± 11.40 out of 100 (range 51.11–100), and 33% of patients scored 73.3 or lower. Item means ranged from 4.85 to 4.98 out of 6. Being asked which option the patient preferred was the lowest-rated step, and being told that a decision was needed was the highest. Perceived shared decision-making did not differ by any patient characteristic (all P > .63).
Conclusion: Patients perceived a high and uniform level of shared decision-making after structured counselling but asking for the patient’s preference was the weakest step. Training anaesthesia nurses and anaesthetists to ask explicitly for patient preference is a simple, targeted improvement.
