Equipoise: The relationships among power as knowing participation in change, engagement in healthcare decision-making, and patients' satisfaction with healthcare decision-making

Patients' participation in their own healthcare decisions is an expectation in emerging patient-centered healthcare models. Understanding patients' ability to participate in their own healthcare decisions is integral to their sense of well-being and self-determination of desired healthcare outcomes. Equipoise is a balance at a decision point in a patient's healthcare, and all patients uniquely construct their own equipoise. The purpose of this study was to investigate the relationships among power as knowing participation in change, engagement, and satisfaction with healthcare decision-making as theoretical manifestations of patient equipoise. This study was based on the theoretical foundations of Barrett's Theory of Power as Knowing Participation in Change and Hibbard and Mahoney's Theory of Activation.;In this descriptive correlational study, data were analyzed from 98 participants 18 years of age and older, who completed a high school education, could read and speak English, and had at least one diagnosed chronic illness. Data analyses included descriptive and inferential statistics.;The findings of this study revealed moderate to high participant scores on measures of power as knowing participation in change, engagement, and satisfaction with decision-making and significant correlations, with moderate positive magnitude among these variables. Stepwise multiple regression revealed that the linear combination of the freedom dimension of power and engagement was a significant predictive of satisfaction with decision-making. However, the choices, awareness, and involvement in creating change dimensions of power failed to enter the regression due to multicollinearity. Independent t-tests compared the differences between females and males on all research variables, and found that females scored significantly higher than males on engagement. These research findings are discussed in relation to the current literature and the theoretical basis of the study.;The findings of this study are significant for nursing science and research through nursing theory testing to contribute to nursing knowledge regarding patient equipoise in healthcare decision-making. This study supports the use of Barrett's power as knowing participation theory, and contributes to the understanding of how a patient power profile is associated with their healthcare decision-making. Blending of power as knowing participation and the theory of activation explained and further expanded the view of the concept of equipoise.;Understanding patients' capacity to participate knowingly and their engagement in healthcare decision-making can influence the nursing care needed for patients to achieve equipoise and their own optimal healthcare outcomes. This study also informs nursing education concerning the patient process of healthcare decision-making. Patient-centered care is based on a deep respect for patients as unique living beings, and the obligation to care for them on their terms. The professional preparation and education of nurses directly influences the quality of patient-centered care.