Shared decision-making (SDM) is regarded as a core principle of patient-centered care. However, its implementation in the emergency department (ED) is challenging due to time pressure and acute circumstances. Patient participation may also be hindered by limited understanding of SDM. This study assessed SDM knowledge among ED visitors to inform future interventions.

A cross-sectional study was conducted in the ED of a university hospital. Fifty adult patients with non-life-threatening conditions and accompanying persons were recruited. Demographics, healthcare exposure, and SDM knowledge (measured with the validated 24-item SDM - K - Q questionnaire) were collected. Associations between participant characteristics and SDM knowledge were examined using multivariable linear regression.

Of 50 participants, 26 (52 %) were female and 33 (66 %) were accompanying persons. The largest age group (26 %) was 18–27 years. Over half (54 %) reported more than 20 prior doctor visits, and 40 % had higher vocational education. Mean SDM - K - Q score was 71.1 % (SD 15). Participants aged 48–57 years scored significantly higher (84.8 %) than younger groups. Women outperformed men (76.7 % vs. 65.9 %; mean difference 10.8 %, 95 % CI 2.3–19.3). A higher number of prior doctor visits was associated with greater SDM knowledge (β = 14.1 %, p  = 0.034). Scores did not differ between patients and accompanying persons, nor across educational levels.

ED visitors showed moderate SDM knowledge, with age and prior healthcare experience being positive predictors. Targeted SDM education and skills training—particularly for younger and less experienced patients—may strengthen shared decision-making in acute care.