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

Beach, Mary Catherine; Duggan, Patrick; Moore, Richard D.

doi:10.1007/s11606-007-0241-1

Cited by 66 publications

(48 citation statements)

References 20 publications

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“…While qualitative studies suggest patients with HIV highly value involvement in treatment decisions, 16,17 few quantitative studies have investigated their decision-making preferences. To this end, Beach et al found that 63% of patients with HIV preferred shared decision-making and that these patients were more likely to adhere to antiretroviral therapy than those who preferred their providers make decisions 18 , suggesting that increased patient participation in the setting of HIV may lead to increased treatment adherence.…”

Section: Introductionmentioning

confidence: 99%

Decision-Making Role Preferences Among Patients with HIV: Associations with Patient and Provider Characteristics and Communication Behaviors

et al. 2010

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BACKGROUND: A preference for shared decision-making among patients with HIV has been associated with better health outcomes. One possible explanation for this association is that patients who prefer a more active role in decision-making are more engaged in the communication process during encounters with their providers. Little is known, however, about patient and provider characteristics or communication behaviors associated with patient decision-making preferences in HIV settings. OBJECTIVE:We examined patient and provider characteristics and patient-provider communication behaviors associated with the decision-making role preferences of patients with HIV. DESIGN:Cross-sectional analysis of patient and provider questionnaires and audio recorded clinical encounters from four sites.PARTICIPANTS: A total of 45 providers and 434 of their patients with HIV. MEASURES:Patients were asked how they prefer to be involved in the decision-making process (doctor makes all/most decisions, patients and doctors share decisions, or patients make decisions alone). Measures of provider and patient communication behaviors were coded from audio recordings using the Roter Interaction Analysis System. MAIN RESULTS:Overall, 72% of patients preferred to share decisions with their provider, 23% wanted their provider to make decisions, and 5% wanted to make decisions themselves. Compared to patients who preferred to share decisions with their provider, patients who preferred their provider make decisions were less likely to be above the age of 60 (ARR 0.09, 95% CI 0.01-0.89) and perceive high quality provider communication about decision-making (ARR 0.41, 95% CI 0.23-0.73), and more likely to have depressive symptoms (ARR 1.92, 95% CI 1.07-3.44). There was no significant association between patient preferences and measures of provider or patient communication behavior. CONCLUSION:Observed measures of patient and provider communication behavior were similar across all patient decision-making role preferences, indicating that it may be difficult for providers to determine these preferences based solely on communication behavior.Engaging patients in open discussion about decisionmaking preferences may be a more effective approach.

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Section: Introductionmentioning

confidence: 99%

Decision-Making Role Preferences Among Patients with HIV: Associations with Patient and Provider Characteristics and Communication Behaviors

et al. 2010

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“…Studies have found that end users who report greater involvement in their medical care are more satisfied with their healthcare workers. 24 They also report more understanding, reassurance and perceived control over their illness. Their medical conditions also improve.…”

Section: Discussionmentioning

confidence: 99%

“…Another study found that end users who preferred a more active role were less satisfied when their nurses and physicians did not support their preferences. 24 While ART helps volunteer workers to regain the capacity to work, other economic support is needed to enable them and their households to re-establish their livelihoods, especially in resource-constrained settings. 20 Health facilities should continuously improve quality and processes to meet the changing requirements and expectations of end users.…”

Section: Discussionmentioning

confidence: 99%

End-user centeredness in antiretroviral therapy services in Nigerian public health facilities

Chiegil

Zungu

Jooste

2014

South African Family Practice

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Objective: To describe the perception of end users with regard to end-user centeredness in antiretroviral therapy (ART) service provision in Nigerian public health facilities.Design: A qualitative design was followed.Subjects and setting: Unstructured focus group discussions were conducted with end users (n = 64) in six locations across the six different geopolitical zones of Nigeria.Outcome measures: Data were analysed using the framework approach and Weft QDA ® version 1.0.1. qualitative data analysis software. Results:The results focused on end users' participation in their care, ranging from understanding their diagnosis, choosing from available treatment options and places, and caring for their colleagues and themselves.Conclusion: End-user focused ART service provision positions end users to play key roles in decision-making with regard to their care. The findings of this study will be useful for nurses and other healthcare workers when promoting end-user centeredness in ART service provision.Peer reviewed.

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“…De ahí que sea entendible el hecho de que a medida que se tiene más tiempo viviendo con el VIH, las personas precisan de modos diferentes de interacción, en los que destaca por ejemplo la toma de decisiones (Beach, Duggan & Moore, 2007). Empero, sobre este fenómeno hay que aclarar que no nos referimos a una respuesta discreta y particular que ocurre en un momento del continuo de interacción, i.e., consumir o no los medicamentos, acudir o no a las citas programadas con el personal de salud, etcétera (Denburg et al, 2009;Kumar et al, 2010), sino a modos consistentes de interacción, esto es, a una diversidad de comportamientos que darían cuenta del perfil funcional del que se hizo mención antes (Ribes, 2009).…”

Section: Discussionunclassified

Variables Psicológicas y Adhesión en Personas con VIH: Evaluación en función del Tiempo de Infección

et al. 2011

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ResumenSe realizó un estudio transversal con el objetivo de evaluar la influencia de un conjunto de variables psicológicas sobre los comportamientos de adhesión al tratamiento en función del tiempo de infección en meses. Participaron 93 personas con VIH, quienes contestaron dos instrumentos: 1) Variables psicológicas y comportamientos de adhesión, y 2) Situaciones vinculadas con estrés. Se emplearon los siguientes procedimientos estadísticos: la ji al cuadrado de Pearson, la U de Mann-Whitney y un análisis de regresión múltiple. Los análisis de regresión revelaron una influencia diferenciada de las variables psicológicas en función del tiempo de infección: en el grupo de personas con ≤ 42 meses, los predictores de los comportamientos de adhesión fueron una buena motivación, un óptimo desempeño competencial presente y bajos niveles de estrés vinculados con tolerancia a la frustración. En el grupo con 43 o más meses los predictores fueron una buena motivación y bajos niveles de estrés vinculados con toma de decisiones. El tiempo de infección en meses constituye una variable crítica respecto de la forma en que operan las variables psicológicas sobre la práctica de los comportamientos de adhesión en personas con VIH expuestas a tratamiento con medicamentos antirretrovirales.Palabras clave: VIH, tiempo de infección, motivos, competencias conductuales, situaciones vinculadas con estrés. AbstractThis cross-sectional study was carried out to assess the influence of psychological variables on antiretroviral treatment adherence behaviors, based on length of infection in months. Participants included ninety-three HIV-positive persons, who answered two self-administered questionnaires: 1) Psychological variables and adherence behaviors, and 2) Stress-related situations. Three consecutive statistical testing procedures were applied for data analysis: Pearson's chi-square, Mann-Whitney U, and multiple regressions. Regression analyses found psychological variables influencing adherence behaviors in different ways based on length of infection: in the group of persons with ≤ 42 months, psychological predictors were a good motivation, an optimal competential performance and low stress-related with tolerance to frustration, whereas in the group of persons with 43 or more months predictors were a good motivation and low stress-related with decisionmaking. Results strongly support the tenet that length of infection is a critical variable related to psychological variables influencing adherence behaviors among HIV-positive persons under antiretroviral treatment.

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

Cited by 66 publications

References 20 publications

Decision-Making Role Preferences Among Patients with HIV: Associations with Patient and Provider Characteristics and Communication Behaviors

Decision-Making Role Preferences Among Patients with HIV: Associations with Patient and Provider Characteristics and Communication Behaviors

End-user centeredness in antiretroviral therapy services in Nigerian public health facilities

Variables Psicológicas y Adhesión en Personas con VIH: Evaluación en función del Tiempo de Infección

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