Using hybrid consistent fuzzy preference relations-importance-performance analysis model to improve shared decision-making quality based on orthopaedic nurses' perceptions

Purpose To understand key factors for shared decision-making (SDM) and the quality improvement of nursing decisions in the orthopaedic clinical environment. Method This study applied the consistent consistent fuzzy preference relations (CFPRs) and importance-performance analysis (IPA) methods to explore the attribute weights and SDM performance, respectively. The dataset was collected from 16 orthopaedic clinical nurses' experiences in a third-grade and first-level general hospital in Taizhou, China. This study was performed according to the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) guidelines. Results The results showed that I made clear to my patient or patient's family that a nursing care decision needs to be made, I explained the advantages and disadvantages of the nursing care options to my patient or patient's family and I told my patient or patient's family that there are different nursing care options for caring his/her medical condition were key factors for affecting SDM. The statistical significance confidence and difference error of weight results were 98.321% and 1.679%, respectively. In addition, I asked my patient or patient's family which nursing care option he/she prefers was the key factor for improving orthopaedic clinical nursing in the case hospital. Conclusion The hybrid CFPRs-IPA model can help hospital managers effectively understand the key factors of SDM quality and improve the orthopaedic clinical nursing performance from nurses' perspectives. Relevance to Clinical Practice A quantitative decision-making model can help nurses understand the key factors affecting the quality of SDM in nursing decision-making and promote nursing decision-making and patient-centred nursing service quality. A series of corresponding SDM training courses (i.e. concepts, knowledge and skills) can be provided for hospital and nursing department managers to maximise the potentially available resources. Patient or Public Contribution The clinical care process should be committed to involving patients in their care decisions and also provide an opportunity for patients to gain a comprehensive understanding of the care decision-making process in order to inform future patient contributions to care decisions.

Automated summary

This study explored the key factors for shared decision-making (SDM) and the quality improvement of nursing decisions in the orthopaedic clinical environment using consistent fuzzy preference relations (CFPRs) and importance-performance analysis (IPA) methods. The results highlighted the importance of informing patients or their families about the need for nursing care decisions, explaining the advantages and disadvantages of care options, and informing them about the availability of different care options. Additionally, asking patients or their families about their care preferences was identified as a key factor for improving orthopaedic clinical nursing.