Shared Decision-Making in Korean Healthcare: A Scoping Review.

Abstract

Shared decision-making (SDM) is a collaborative process in which patients and healthcare professionals jointly make informed healthcare decisions. Although SDM is increasingly recognized as a core component of patient-centered care, no comprehensive synthesis has yet mapped SDM research in Korea. This scoping review aimed to examine the scope, key themes, and characteristics of SDM studies in Korean healthcare with a focus on conceptual frameworks, instruments, decision aids, and implementation contexts. Following the Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines, we systematically searched nine electronic databases (PubMed, Embase, PsycINFO, CINAHL, Web of Science, and four Korea-specific databases: KoreaMed, RISS, KISS, and DBpia) for English- and Korean-language studies published until 2024. Eligible studies involved Korean populations and addressed SDM or patient participation in healthcare decision-making. Of the 9,177 records identified, 62 met the inclusion criteria. Most studies used quantitative designs (74.2%), followed by mixed-methods (14.5%), and qualitative (11.3%) approaches. Research has primarily focused on end-of-life care, oncology, and family medicine/primary care across hospital and community settings. Key themes included patient experiences, barriers and facilitators, providers' perspectives, and intervention outcomes. Although several studies have referenced conceptual models, their practical applications are limited. A few culturally tailored frameworks and measurement tools reflect efforts to adapt SDM to the Korean context. Several decision aids and educational interventions have been evaluated in clinical settings. The implementation and uptake of SDM are influenced by multilevel factors, including the individual, interpersonal, organizational, and policy domains. This review highlights a growing but thematically fragmented body of SDM research in Korea. Despite increasing interest, conceptual integration, validated instruments, and systematic implementation remain underdeveloped. To advance SDM practice and policy, culturally grounded frameworks, rigorously validated evaluation tools, and system-level support tailored to Korea's sociocultural and clinical contexts are essential. Findings from the Korean experience may provide valuable insights into advancing SDM efforts in culturally and structurally similar global settings.