The concept of decisional control: building the base for evidence-based nursing practice

The purposes of this article are to add clarification to the meaning of decisional control and provide a review of research related to the concept.

A summary of the definitions of decisional control is followed by a discussion of the characteristics of the concept. The concept of decisional control includes the ability or power to decide what will be one's involvement in health care decisions.

Studies on decisional control have tended to center on inpatient, physician office, or clinic settings with a focus on the diagnosis of cancer in which multiple medical treatment decisions arise. Most of the research thus far has been performed in the United States and Canada related to medical treatment. At this point, it is not entirely clear how patient preferences for decisional control relate to health outcomes.

An overview of the tools available to measure decisional control follows the review of the research.

Future research needs to focus on the identification of the differences in decisional control by country, in differing cultural and ethnic groups within countries, and in various geographical areas of countries. The relationship of patient characteristics (e.g., age, gender, education, and income) to decisional control preferences is not clearly identified. A large gap in the research relates to how nurses can facilitate preferred decisional control to improve patient outcomes through evidence-based nursing practice.