Preferences and Perceived Involvement in Treatment Decision Making among Chinese Patients with Chronic Hepatitis

Abstract

Patients' preferences for participation in treatment decision making should be considered seriously by doctors during the encounter. Health providers should make a greater effort to improve doctor-patient communication and decrease the mismatch between patients' perceived and preferred decisional role.

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

“…In addition, although there was a trend towards lower education and lower DCPs, we found no statistically significant relationship between education and DCPs. Lower education status was found to be associated with lower levels of DCPs in some studies 7,10,16,36 but not associated in others. 9,21,35,37 …”

“…Consistent with other studies, we found that older age was associated with lower DCPs. 9,10,16,33 The prevalence of low DCPs in older patients has been attributed to severity of disease, lack of knowledge, low self-efficacy, and fear regarding their illness. 33-35 It is important to note that despite a clear association of DCPs with age, the majority of our older population preferred to share decisions with their doctor or make their own decisions.…”

“…7-14 However, many of these studies were conducted among homogeneous populations (e.g., one race/ethnic group, such as African Americans or Asians) or among younger individuals. 7,10,15 Among these studies, low DCPs have been associated with older age, lower education, minority status, and, for some groups, such as Mexican Americans and Korean Americans, less acculturation to the U.S. 7,9,10,16,17 Studies that have included older adults have only focused on one disease process, such as prostate or breast cancer, and not on a range of multi-morbidity. 18-21 …”

Congruence between patients’ preferred and perceived participation in medical decision-making: a review of the literature

“…Six studies on various patient populations (women with breast cancer [35,54], patients with lung cancer [53], patients with asthma [40] patients visiting their GP [43] and general public [20] found that older patients preferred more often a passive role in medical decision-making, four studies (three among patients with breast cancer [12,35,44] and one among patients with chronic hepatitis [50] found that younger patients preferred more often an active role, and three studies (all among patients with breast cancer [18,35,54] found that younger patients preferred more often a shared role. Finally, three studies (one among patients with breast cancer [37], one among patients with colorectal cancer [33] and one among patients with different types of cancer [38] found no association between age and preferred role in medical decision-making.…”

“…Five studies (four among patients with breast cancer [12,26,42,54] and one among the general public [20]) found that higher educated people more often prefer an active role, two studies (one among patients with breast cancer [50] and one among patients with asthma [40]) found that lower educated people more often prefer a passive role. One study among patients with breast cancer reported no association between education and perceived role [35].…”