Control preferences in treatment decisions among older adults — Results of a large population-based study

Lechner, Sabine; Herzog, Wolfgang; Boehlen, F.; Maatouk, Imad; Saum, Kai Uwe; Brenner, Hermann; Wild, Beate

doi:10.1016/j.jpsychores.2016.05.004

Cited by 22 publications

(34 citation statements)

References 40 publications

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“…Degner et al (1992) revealed that age was the most important predictor of DCP preferences and that older subjects preferred less control (Degner & Sloan, 1992). There was a similar finding for those still at work, but this is likely related to age (Lechner et al, 2016). In our study, DCPs were not influenced by gender.…”

Section: Discussionsupporting

confidence: 71%

Decisional control preferences of patients with advanced cancer receiving palliative care

et al. 2017

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Objective:Understanding patients' decisional control preferences (DCPs) is important to improving the quality of care and the satisfaction of patients who have advanced cancer with their care. In addition to passive decisional control (i.e., the patient prefers his/her doctor or family caregiver to make a decision on their behalf) and active decisional control (i.e., the patient decides alone), shared decisional control, where patients and caregivers decide together, could be more appropriate. The primary aim of our study was to describe the decision-making process and the DCPs of patients with advanced cancer receiving palliative care in France.Method:We conducted a prospective survey with advanced cancer patients referred to a palliative care team in an outpatient setting. We collected information about patients' demographic and clinical characteristics using the Decision Control Preference Scale, the Satisfaction with the Decisions and Care questionnaire, and the Understanding of Illness questionnaire.Results:A total of 200 patients were evaluable. The median age was 63.5 years and 53.5% female. The cancers most commonly represented were gastrointestinal and breast. A total of 72 patients (36.2%) preferred active decisional control, 52 (26.1%) preferred shared decisional control, and 75 (37.7%) preferred passive decisional control. Younger age (p = 0.003), higher education (p < 0.001), and employment status (p = 0.046) were found to be associated with active or shared DCPs. Some 82% of patients were satisfied with the decision-making process, 35% of whom expressed wishes that did not match the actual decision-making process. Only 23% of patients thought they could be cured of their illness, and 47% thought that their treatment would “get rid of ” their disease.Significance of Results:The decision-making processes are shared in the three models of DCPs in our cohort of French patients with advanced cancer. Further prospective studies are needed.

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Section: Discussionsupporting

confidence: 71%

Decisional control preferences of patients with advanced cancer receiving palliative care

et al. 2017

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“…We excluded some studies that investigated the preferences of patients with multimorbidity or clinicians, in contexts that we judged to be different to the aim of this review. These included patient preferences for healthcare delivery,59 60 levels of engagement with self-management practices61 62 and clinicians’ experiences of the management of patients with multimorbidity 18 63 64. While these studies represent very important areas of research, they were not within the scope of our aim in this review, that is, identifying studies that report the health outcome and treatment priorities of patients with multimorbidity or those of clinicians in relation to patients with multimorbidity.…”

Section: Discussionmentioning

confidence: 99%

Priorities of patients with multimorbidity and of clinicians regarding treatment and health outcomes: a systematic mixed studies review

et al. 2020

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ObjectivesTo identify studies that have investigated the health outcome and treatment priorities of patients with multimorbidity, clinicians or both, in order to assess whether the priorities of the two groups are in alignment, or whether a disparity exists between the priorities of patients with multimorbidity and clinicians.DesignSystematic review.Data sourcesMEDLINE, EMBASE, CINHAL and Cochrane databases from inception to May 2019 using a predefined search strategy, as well as reference lists containing any relevant articles, as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Cochrane guidelines.Eligibility criteriaWe included studies reporting health outcome and treatment priorities of adult patients with multimorbidity, defined as suffering from two or more chronic conditions, or of clinicians in the context of multimorbidity or both. There was no restriction by study design, and studies using quantitative and/or qualitative methodologies were included.Data synthesisWe used a narrative synthesis approach to synthesise the quantitative findings, and a meta-ethnography approach to synthesise the qualitative findings.ResultsOur search identified 24 studies for inclusion, which comprised 12 quantitative studies, 10 qualitative studies and 2 mixed-methods studies. Twelve studies reported the priorities of both patients and clinicians, 10 studies reported the priorities of patients and 2 studies reported the priorities of clinicians alone. Our findings have shown a mostly low level of agreement between the priorities of patients with multimorbidity and clinicians. We found that prioritisation by patients was mainly driven by their illness experiences, while clinicians focused on longer-term risks. Preserving functional ability emerged as a key priority for patients from across our quantitative and qualitative analyses.ConclusionRecognising that there may be a disparity in prioritisation and understanding the reasons for why this might occur, can facilitate clinicians in accurately eliciting the priorities that are most important to their patients and delivering patient-centred care.PROSPERO registration numberCRD42018076076.

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“…In the last decades, many self‐report instruments have been developed to assess the extent to which patients want to be informed and involved in decisions about their care, the most widely used of which are the Control Preference Scale 6 and the Autonomy Preference Index 7 . Research has shown that most patients desire a collaborative or autonomous role in their medical decisions and that many of them do not feel as involved as they would want 3,8 . Furthermore, less perceived involvement or a mismatch between preferred and experienced involvement has been shown to be related to poorer satisfaction, adherence and quality of life 9‐13 .…”

Section: Introductionmentioning

confidence: 99%

Cross‐cultural validation of the patient‐practitioner orientation scale among primary care professionals in Spain

Perestelo‐Pérez

Rivero‐Santana²,

González‐González

et al. 2020

Health Expectations

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Background In recent decades, many self‐report instruments have been developed to assess the extent to which patients want to be informed and involved in decisions about their health as part of the concept of person‐centred care (PCC). The main objective of this research was to translate, adapt and validate the Patient‐Practitioner Orientation Scale (PPOS) using a sample of primary care health‐care professionals in Spain. Methods Baseline analysis of PPOS scores for 321 primary care professionals (general practitioners and nurses) from 63 centres and 3 Spanish regions participating in a randomized controlled trial. We analysed missing values, distributions and descriptive statistics, item‐to‐scale correlations and internal consistency. Performed were confirmatory factor analysis (CFA) of the 2‐factor model ( sharing and caring dimensions), scale depuration and principal component analysis (PCA). Results Low inter‐item correlations were observed, and the CFA 2‐factor model only obtained a good fit to the data after excluding 8 items. Internal consistency of the 10‐item PPOS was acceptable (0.77), but low for individual subscales (0.70 and 0.55). PCA results suggest a possible 3‐factor structure. Participants showed a patient‐oriented style (mean = 4.46, SD = 0.73), with higher scores for caring than sharing . Conclusion Although the 2‐factor model obtained empirical support, measurement indicators of the PPOS ( caring dimension) could be improved. Spanish primary care health‐care professionals overall show a patient‐oriented attitude, although less marked in issues such as patients’ need for and management of medical information.

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Control preferences in treatment decisions among older adults — Results of a large population-based study

Cited by 22 publications

References 40 publications

Decisional control preferences of patients with advanced cancer receiving palliative care

Decisional control preferences of patients with advanced cancer receiving palliative care

Priorities of patients with multimorbidity and of clinicians regarding treatment and health outcomes: a systematic mixed studies review

Cross‐cultural validation of the patient‐practitioner orientation scale among primary care professionals in Spain

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