Decisional Control Preferences of Hispanic Patients With Advanced Cancer From the United States and Latin America

Yennurajalingam, Sriram; Parsons, Henrique A.; Duarte, Eva Rossina; Palma, Alejandra; Bunge, Sofía; Palmer, J. Lynn; Delgado-Guay, Marvin Omar; Allo, Julio; Bruera, Éduardo

doi:10.1016/j.jpainsymman.2012.08.015

Cited by 32 publications

(47 citation statements)

References 27 publications

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“…17,38 In a meta-analysis of end-of-life decision making among racially and ethnically diverse groups, Kwak and Haley found that Korean and Mexican Americans, regardless of acculturation status, were more likely to designate a family member as the primary medical decision maker. 39 However, other studies found no association between DCPs and minority status or acculturation to the U.S. 13,16 Regardless, it is important to elicit and honor different views concerning DCPs because the value of autonomy in decision making is often culturally and contextually dependent. 37,38 …”

Section: Discussionmentioning

confidence: 99%

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“Doctor, Make My Decisions”: Decision Control Preferences, Advance Care Planning, and Satisfaction With Communication Among Diverse Older Adults

Chiu

Feuz

McMahan

et al. 2016

Journal of Pain and Symptom Management

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Context Culturally diverse older adults may prefer varying control over medical decisions. Decision control preferences (DCPs) may profoundly affect advance care planning (ACP) and communication. Objectives To determine the DCPs of diverse, older adults and whether DCPs are associated with participant characteristics, ACP, and communication satisfaction. Methods A total of 146 participants were recruited from clinics and senior centers in San Francisco. We assessed DCPs using the Control Preferences Scale: doctor makes all decisions (low), shares with doctor (medium), makes own decisions (high). We assessed associations between DCPs and demographics; prior advance directives; ability to make in-the-moment goals of care decisions; self-efficacy, readiness, and prior asked questions; and satisfaction with patient-doctor communication (on a 5-point Likert scale), using Chi-square and Kruskal-Wallis analysis of variance. Results Mean age was 71±10 years, 53% were non-white, 47% completed an advance directive, and 70% made goals of care decisions. Of the sample, 18% had low DCPs, 33% medium, and 49% high. Older age was the only characteristic associated with DCPs (low: 75 years ±11, medium: 69±10, high: 70±9, P=0.003). DCPs were not associated with ACP, in-the-moment decisions, or communication satisfaction. Readiness was the only question-asking behavior associated (low: 3.8±1.2, medium: 4.1±1.2, high: 4.3±1.2, P=0.05). Conclusion Nearly one-fifth of diverse, older adults want doctors to make their medical decisions. Older age and lower readiness to ask questions were the only demographic variables significantly associated with low DCPs. Yet, older adults with low DCPs still engaged in ACP, asked questions, and reported communication satisfaction. Clinicians can encourage ACP and questions for all patients, but should assess DCPs to provide the desired amount of decision support.

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Section: Discussionmentioning

confidence: 99%

“…Patients who are more passive within clinical encounters, particularly minorities, are less likely to receive information from clinicians. 12,13,22-25 These patients also tend to report lower satisfaction with communication. 20-23 …”

Section: Introductionmentioning

confidence: 99%

“Doctor, Make My Decisions”: Decision Control Preferences, Advance Care Planning, and Satisfaction With Communication Among Diverse Older Adults

Chiu

Feuz

McMahan

et al. 2016

Journal of Pain and Symptom Management

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“…In a previous article, we reported that Hispanics from the U.S. had more active DCPs than Hispanics from Latin America. 12 The objective of this paper was to report our findings regarding the association between DCPs, sociodemographic and clinical characteristics, and Hispanic patients’ preferences for disclosure of diagnostic and prognostic information. We also determined the concordance between patients’ DCPs and their self-reported DCPs related to their cancer care and identified the factors that influence patient satisfaction with the decision control process.…”

Section: Introductionmentioning

confidence: 99%

Decisional Control Preferences, Disclosure of Information Preferences, and Satisfaction Among Hispanic Patients With Advanced Cancer

Noguera

Yennurajalingam

Torres-Vigil

et al. 2014

Journal of Pain and Symptom Management

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Context Studies to determine the decisional control preferences (DCPs) in Hispanic patients receiving palliative care are limited. Objectives The aims of this study were to describe DCPs, disclosure of information, and satisfaction with decision making among Hispanics, and to determine the degree of concordance between patients’ DCPs and their self-reported decisions. Methods We surveyed 387 cancer patients referred to outpatient palliative care clinics in Argentina, Chile, Guatemala, and the U.S. DCPs were measured with the Control Preference Scale, disclosure preferences with the Disclosure of Information Preferences questionnaire, and satisfaction with care with the Satisfaction with Decision Scale. Results In this study, 182 patients (47.6%) preferred shared decisional control, 119 (31.2%) active decisional control, and 81 (21.2%) preferred a passive approach. Concerning diagnosis and prognosis, 345 (92%) patients wanted to know their diagnosis, and 355 (94%) wanted to know their prognosis. Three hundred thirty-seven (87%) patients were satisfied with the decision-making process. DCPs were concordant with the self-reported decision-making process in 264 (69%) patients (weighted kappa, 0.55). Patients’ greater satisfaction with the decision-making process was correlated with older age (P≤0.001) and with a preference for enhanced diagnostic disclosure (P≤0.024). Satisfaction did not correlate with concordance in the decision-making process. Conclusion The vast majority preferred a shared or active decision-making process and wanted information about their diagnosis and prognosis. Older patients and those who wanted to know their diagnosis seemed to be more satisfied with the way treatment decisions were made.

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“…However, several researchers have observed passive attitudes toward decision-making among cancer patients; in fact, a recent research review has shown that passive attitudes remain dominant in patients 3 . Although many researchers accept the importance of shared attitudes in decision-making, these observations might be caused by differences in patient ethnicity, age 4,5 , and background experience 6 . According to a recent study, patients prefer to be controlled by the physician in decision-making; they trust their physician 7 .…”

Section: Introductionmentioning

confidence: 99%

Rapport between Cancer Patients and Their Physicians is Critical for Patient Satisfaction with Treatment Decisions

2016

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Decisional Control Preferences of Hispanic Patients With Advanced Cancer From the United States and Latin America

Abstract: HUSs had more active DCPs than HLAs did. Among HUSs, acculturation did not seem to play a role in DCP determination. Our findings confirm the importance of family participation for both HUSs and HLAs. However, HUSs were less likely to want family members to make decisions on their behalf.

Cited by 32 publications

References 27 publications

“Doctor, Make My Decisions”: Decision Control Preferences, Advance Care Planning, and Satisfaction With Communication Among Diverse Older Adults

“Doctor, Make My Decisions”: Decision Control Preferences, Advance Care Planning, and Satisfaction With Communication Among Diverse Older Adults

Decisional Control Preferences, Disclosure of Information Preferences, and Satisfaction Among Hispanic Patients With Advanced Cancer

Rapport between Cancer Patients and Their Physicians is Critical for Patient Satisfaction with Treatment Decisions

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