Decision-making preference and opportunity in VA ambulatory care patients: Association with patient satisfaction

Abstract

Using data from the Veterans Health Study, associations were examined for decision-making preference, decision-making opportunity, and satisfaction with medical care among a sample of 266 men who use Department of Veterans Affairs (VA) ambulatory health care services. Results indicated that veterans with a high preference for involvement in decision-making and low provider-offered decision-making opportunities had significantly lower satisfaction with medical care compared to veterans with either low preference for decision-making involvement with high or low opportunity, or those with a high decision-making preference and high decision-making opportunity. The findings suggest that health care providers may increase patient satisfaction with medical care by providing opportunities for decision-making to patients who prefer involvement in their health care decision-making. Provider strategies for increasing patient decision-making involvement are discussed.

Informed Decision-Making and Colorectal Cancer Screening

“…In a study by Harvey et al using the Decision-Making Preference Scale among the 266 respondents in the Veterans Health Study, a moderate preference for physician decisionmaking in general was found. 21 Prior work in which the Decision-Making Preference Scale was administered to nonveteran patients in the outpatient setting had similar results. 22 Conversely, in a study by Mazur et al conducted at an outpatient primary care clinic within a VA medical center addressing decision-making toward invasive procedures and therapeutic interventions, 68% of the respondents preferred a shared decision-making style whereas 21% desired physician-based decision-making and 11% favored patient-based decision-making.…”

Is Patients’ Preferred Involvement in Health Decisions Related to Outcomes for Patients with HIV?

“…We do know from previous studies that the benefits of being involved in one's own health care are not influenced by the patient's preference for involvement, such that patients seem to benefit from becoming more involved in their own health care regardless of how much they want to be involved 9,10 . A considerable amount of research is aimed at identifying which factors are related to patient preference for involvement in decisions 11 , and 1 study has found that patients who prefer a more active role are less satisfied when their physicians do not support their preference 12 .…”

Justice in Health Care Decision-Making: Patients’ Appraisals of Health Care Providers and Health Plan Representatives

“…Specifically, patients who reported better health rated their interactions with health plans as lower on Impartiality and their interactions with providers as lower on both Impartiality and Trust. There is some evidence that healthy patients have a stronger preference for autonomy and control over health care decision-making than do patients in poor health (Harvey et al, 1999). In the present sample, it is possible that healthy patients' preferences for autonomy and decision control were not met, leading them to appraise their interactions more negatively than patients who were more severely ill, who may have had lower expectations for autonomy and decision control.…”

“…2. Consistent with the perspective advanced by Fondacaro (1995) as well as empirical research on patient satisfaction (Guyatt et al, 1995;Harvey et al, 1999;LaVeist et al, 2000;Martin et al, 2001;Pellegrin et al, 2001;Thom et al, 1999) and procedural justice (Leventhal, 1980;Tyler, 1989), patients will use criteria to evaluate procedural justice in the health care context (with both providers and health plans) that have roots in fundamental legal principles of due process: whether they are treated with personal dignity and respect in a manner that affirms trust (trust), whether they are treated in a neutral and nondiscriminatory manner (impartiality), and whether they are provided an opportunity to participate in decisionmaking (voice/participation). 3.…”

“…For example, patient satisfaction has been associated with physician/patient relationships characterized by trust (LaVeist et al, 2000;Thom et al, 1999), personal respect (Pellegren et al, 2001), open communication about health status and treatment (Ende et al, 1989;Nease and Brooks, 1995), and increased opportunities for patient input into treatment decisions (Guyatt et al, 1995;Harvey et al, 1999;Martin et al, 2001). Overall, this line of research is important because the provider/patient relationship is a primary means by which patients obtain treatment relevant information (Ong et al, 1995).…”