Characterizing patients and family decision-maker's expectations of participation in decision-making on...

Shared decision-making (SDM) is a healthcare delivery model that advocates for patient-centered care in clinical practice. Examining patients and family decision-makers' preferences on thromboprophylaxis is critical to achieving this goal.

This study aims to outline the expectations of family decision-makers regarding participation in decision-making on thromboprophylaxis.

This descriptive study examined a cross-section of a sample in the Ningxia Hui Autonomous Region People's Hospital, a tertiary hospital in Yinchuan, China, from December 2023 to March 2024. All individuals aged ≥18 years who had undergone orthopedic surgery (total hip arthroplasty, total knee arthroplasty, or hip fracture surgery) and were at high risk for venous thromboembolism (VTE) were included in the study. They were invited to complete the four questionnaires, including the Socio-demographic List, the Control Preferences Scale (CPS, to assess patients' role in medical decision-making), the Expectation of Participation in Medical Decision-Making Scale (to evaluate patients' expectations for participation), and the Preparation for Decision-Making Scale (PrepDM, to assess patients' readiness).

The three profiles were designated as "High Expectation - Active Decision-Making Participation Group"(67.7%), "Medium Expectation - Neutral Decision-Making Participation Group"(26.4%), and "Low Expectation - Indifferent Decision-Making Participation Group"(5.9%). Latent influencing factors include the decision-makers employment status, kinship relationship, and level of preparedness for decision-making. In terms of employment status, the probability of employees (OR = 0.236, 95%CI = 0.062 - 0.898, p = .037) or self-employed individuals (OR = 0.213, 95%CI = 0.057 - 0.796, p = .023) belonging to the high-expectation group is the highest. Meanwhile, in relationships, the probability of spouses (OR = 0.031, 95%CI = 0.002 - 0.508, p = .012) or first-degree relatives (OR = 0.071, 95%CI = 0.008 - 0.673, p = .016) belonging to the high-expectation group is the highest. In PrepDM, the higher the total score of decision-makers, the greater the probability of belonging to the low-expectation group (OR = 1.070, 95%CI = 1.006 - 1.138, p = .031).

This study demonstrated heterogeneity in family decision-maker's expectations of participation in decision-making on thromboprophylaxis.

Stakeholders may use meaningful information to focus efforts on optimizing decisions and to develop customized bundles guided by category profiles.