Introduction

Shared decision-making (SDM) refers to the process by which at least two participants share information and collaborate to reach an agreement on the preferred treatment of both parties [1]. SDM is a process in which decisions are made in a collaborative manner, where reliable information is provided along with alternative options, and consensus is reached that considers the concerns, values, goals, and preferences of patients and their family [2]. Recently, the patient’s participation in decision-making has been emphasized in the process of determining treatment methods, and the informed preferences of patients and their family should play the most important role in the decision-making process [3]. Many organizations around the world are recommending the use of SDM in decision-making in healthcare situations [4, 5].

Self- management is a process of maintaining health through health promotion activities and disease management [6], and hypertensive patients need to adapt to self- management behaviors. Self-management for hypertensive patients includes medication, lifestyle management, and regular hospital visits, etc. [7]. Nurses provide self- management support and decision-making support to patients through these self- management interventions and allow patients to participate in the self- management process and obtain information. SDM is also applied to this process, and by encouraging patient participation in the self- management process and providing necessary support to patients, it improves the quality of the decision-making process and treatment implementation, ultimately improving patient outcomes [2]. In the recent middle-range theory of nursing in hypertensive patients, the concept of SDM was presented to the nursing management process for lifestyle changes in hypertensive patients, and problem-solving through mutual goal setting was emphasized [7]. As such, it is necessary to apply SDM to self- management programs for hypertensive patients (SMPHP).

SDM strengthens patients’ autonomy by providing individualized nursing interventions to patients and taking responsibility for their daily decisions about health problems [8]. In addition, educating and empowering patients to actively participate in their health, improves health outcomes such as compliance with medication [9, 10], overall health status, disease knowledge, and improvement in lifestyle [10]. However, there are concerns that hypertensive patients may not actively participate in the SDM process [11, 12]. Both healthcare providers and patients experience stress about participating in the SDM process for reasons such as unfamiliarity with SDM [12], problems with old age and health literacy, and differences in knowledge between healthcare providers and patients [13].

In this respect, it is necessary to discuss how to effectively apply SDM to SMPHP. To increase the participation of hypertensive patients in decision-making, it is necessary to consider how to form a supportive relationship with medical service providers, motivate patients, and provide accurate and sufficient health information [14]. Regarding the method specifically applied in the SDM process, it would be systematic to consider the three-talk model of SDM as a standard. In the model, the SDM process is explained by dividing it into ’team talk’, ’option talk’, and ’decision talk’ [2].

Hypertension causes various cardiovascular diseases, increases premature mortality, and imposes a significant burden on individuals, family, and society. In Korea, the prevalence of hypertension in those aged 19 and older increased from 23.7% in 2010 to 29.0% in 2020, but the control rate was 47.6%, which has not changed significantly over the past 10 years [15]. In this context, the government is implementing a hypertension registration management project, and each public health center is implementing self-management intervention through health education, individual phone counseling, and visiting health services. However, the application of SDM to SMPHP is insufficient [14]. An integrative review that identified the comprehensive process of SDM in healthcare settings [16] and a systematic literature review of the effects of SDM applied to hypertensive patients were conducted [17], but there was no study on the topic of applying SDM to SMPHP.

There are currently no scoping review papers summarizing existing research on this topic to help identify evidence and methodological differences. Therefore, the scoping review to contrast and discuss existing studies in this field is meaningful due to differences between previous studies, various methodologies, patient populations, inclusion and exclusion criteria. Due to the heterogeneity and scope of available literature, scoping review are acceptable methodologies that can be used rather than systematic reviews that require a narrower selection of research questions and quality evaluation papers [18].

Materials and methods

The proposed scoping review will be conducted using the Arksey and O’Malley methodological framework [18] and follows the Joana Briggs Instituted (JBI) methodology for scoping reviews [19]. A checklist for the development and reporting of this ScR protocol [20] is included within the supplementary material (S1 Checklist) and a full scoping review will be reported according to PRISMA extension for Scoping Review (PRISMA-ScR) [21].

Stage 4: Charting the data

Data extraction.

Data will be extracted using a data extraction tool developed by the researcher based on the data extraction part of the JBI scoping review [18]. The components of the self-management program and the process of SDM will be extracted along with the general characteristics of the literature. The SDM process is divided into team talk, option talk, and decision talk [2] to extract data. The details of the extraction tool are shown in Table 1. Before data extraction, a pilot test will be conducted using the extraction tool for the two selected literature, and then it was confirmed that all relevant results were extracted. The data extraction tool can be modified during the data extraction process and will be written in such a way that one reviewer extracts independently and the other reviewer verifies it. Any disagreement between reviewers will be resolved through discussion during data extraction process.

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Table 1. Data extraction tool.

https://doi.org/10.1371/journal.pone.0309593.t001

Supporting information

Acknowledgments

We would like to thank those who conducted the study for SDM processes implemented within SMPHP so that this study could be conducted.