Inpatient Participation in Patient Safety Behaviors: Decision-Making Typologies from a Qualitative Study

Patient participation in safety behaviors has been recognized as a critical component of reducing medical errors and improving healthcare outcomes in hospitalized settings. However, there is currently a lack of research to understand the decision-making processes that drive these behaviors.

This study aimed to identify and construct the different types of decision-making personas adopted by inpatients when thinking about participating in patient safety.

A qualitative phenomenological study was conducted at a tertiary hospital in Chongqing from October to December 2024. Inpatients meeting the inclusion and exclusion criteria were selected via purposive sampling, and semi-structured interviews were performed to explore their motivation, willingness, decision-making factors, decision-making balance, and effect evaluation during their participation in patient safety decision-making. Data were analyzed using Colaizzi's seven-step method, facilitating the process from raw data to factual labeling and ultimately to the construction of personas dimensions. Patient characteristics were extracted and personas were constructed by artificial intelligence (AI), with the visualization of these personas achieved through a combination of character images and labels.

This study developed four distinct personas that reflect the decision-making types of inpatients' participation in patient safety, with the personas classifications as follows: self-driven decision-makers, passive collaborators, resource-limited decision avoiders, and self-assertive decision-makers.

The diversity of patients' decision-making types necessitates targeted interventions, such as shared decision-making tools, simplified communication, community support provision, and trust reconstruction. Future research should also include longitudinal studies and cross-cultural validation.