The Theory

The Wittmann-Price Theory of Emancipated Decision-making in Women’s Healthcare

 Decision-making about healthcare issues has evolved from a physician-based privilege to a shared decision-making construct. The Wittmann-Price Theory of Emancipated Decision-making (EDM) is a nursing model that considers gender differences in the healthcare environment and calls for the consideration of awareness of social norms as an effecter in women’s decisions about healthcare issues. Social norms have the potential of oppressing free choice, an apparent phenomenon to professional nurses working in women’s health. This phenomenon occurs in healthcare situations that pose several feasible options. Women often feels obligated to choose the most socially accepted option rather than the choice that best suits her personally. This leads to dissatisfied with the decision. Options become socially acceptable for any number of reasons, including empirical evidence.

EDM originally had five subconcepts, awareness of social norms, flexible environment, personal knowledge, reflection, and empowerment. The practice theory was retroductively derived and a concept analysis (2004) was completed to explain its attributes (Wittmann-Price_2004_Concept_Analysis).

The first study to test the theory was completed using infant feeding method (2006) as the clinical exemplar using all five subconcepts (Wittmann-Price_2006_BF_Study).

The second study (Wittmann-Price_Bhattacharya_2008) (2008) used a mixed method approach with a revised emancipated decision-making scale. The clinical exemplar was “pain management in labor”. In this study the results mimics the first study and the same three significant subconcepts were identified:

  • Awareness of social norms;
  • Flexible environment; &
  • Personal knowledge.

The original EDM Scale was revised and the EDMr, with the three significant subconcepts were tested again in a third study (2011) using pain management in labor as the clinical exemplar (Wittmann-Price_Fliszar_Bhattacharya_2011).

Since 2011, many graduate students have used Wittmann-Price Theory of Emancipated Decision-making (EDM) as the theoretical foundation or women’s health studies (Stafanek_2013).

International projects are also using the theory to promote healthcare for women.

The Wittmann-Price Theory of Emancipated Decision-making (EDM) has also been referenced by other authors as a decisional science theory.

Wittmann-Price Theory of Emancipated Decision-making (EDM) is a middle-range theory that explains a phenomenon encountered by professional nurses when promoting shared decision-making for women.

A Development and Revision of the Wittmann-Price Emancipated Decision-Making Scale can be found in the Journal of Nursing Management, volume 22 (3), 361-367.

For further information about the theory or the Revised Emancipated Decision-making Scale (EDM-r) please contact Dr. Ruth Wittmann-Price at or read her biography at

Dr. Ruth Wittmann-Price’s mailing address is
Francis Marion University
Department of Nursing
4822 E. Palmetto St.
Florence, SC 29506