Predictors of hospitalised patients' preferences for physician-directed medical decision-making

Abstract

Almost all patients want doctors to offer them choices and to consider their opinions, but most prefer to leave medical decisions to the doctor. Patients who are male, less educated, more religious and healthier are more likely to want to leave decisions to their doctors, but effects are small.

Determinants of patients’ attitudes toward patient-centered care: A cross-sectional study in Greece

“…For our research purpose though, only hospitalized patients from 13 clinics were included in our study: Internal medicine (two clinics), Cardiology, Neurology, Nephrology, Oncology, General surgery (two clinics), Gynecology, Ophthalmology, Orthopedics, Plastic surgery and Urology). The study was designed to recruit a representative cross section of each one of the 13 clinics with equal numbers of subjects recruited in each one of six design cells that were defined by age (18-40, 41-60, 61-80 years old) and gender, in order to avoid sampling bias, given that these two demographic factors have been repeatedly associated with patient-centered attitudes in previous studies [5][6][7]9]. To ensure sufficient representation, target numbers for each clinic were identified by reviewing the distribution of patients across the clinics within one typical month.…”

“…Patients vary considerably in their preferences for information-seeking, engagement in decision-making and the level of support they need from their physicians [5]. However, this variation has received little research attention in hospitalized patients [6].…”

“…Although better health status has been associated in outpatients with increased need for sharing information and power with the physician [5,7,11], an American study in hospitalized patients demonstrated that better health was associated with their preference to have the physician make their treatment decisions [6], possibly reflecting the influence of different health care contexts and type of decisions that have to be made. Moreover, although an association between the strength of religious beliefs and patient-centered attitudes has been previously described in Greek medical students and physicians, the effect of religious beliefs is an understudied parameter in patients' attitudes [6]; more specifically, there has been described a negative influence on students' attitudes toward sharing information and a positive influence on physicians' psychosocial orientation [12,13]. Furthermore, in primary care settings, psychological co-morbidity was found to have an impact on patients' preferences for shared decision-making [8], while low perceived social support was associated with problematic resident-patient relationships [14].…”

“…Female gender [5][6][7]9], younger age [5][6][7][8][9], higher education [5][6][7][8]10] and higher income [9] have been previously associated with more patient-centered attitudes. Although better health status has been associated in outpatients with increased need for sharing information and power with the physician [5,7,11], an American study in hospitalized patients demonstrated that better health was associated with their preference to have the physician make their treatment decisions [6], possibly reflecting the influence of different health care contexts and type of decisions that have to be made. Moreover, although an association between the strength of religious beliefs and patient-centered attitudes has been previously described in Greek medical students and physicians, the effect of religious beliefs is an understudied parameter in patients' attitudes [6]; more specifically, there has been described a negative influence on students' attitudes toward sharing information and a positive influence on physicians' psychosocial orientation [12,13].…”

What Do You Expect From a Doctor? Six Habits for Healthier Patient Encounters

“…And although patients want to be involved in creating the plan, most are happy to leave the final decisions to their doctor. 5 My neighbors needed to know why their son was sick, when his symptoms would abate, and what signs might signal a setback in his recovery. Plans should also identify the costs, risks, markers, and likelihood of success.…”