Liana Fraenkel1. 1. VA Connecticut Healthcare System, West Haven, USA. liana.fraenkel@yale.edu
Abstract
OBJECTIVE: experts recommend that clinicians tailor their interactions according to each patient's preferred decision style. Because participation is associated with improved clinical outcomes, factors which modify preferred role should be addressed before determining the level at which patients wish to participate. The objective of this study was to determine if certainty related to initiating treatment is related to preferred role in decision making. METHODS: we conducted face-to-face interviews with 142 patients eligible for the treatment of hepatitis C. Preferred role in decision making was measured using the Control Preferences Scale and certainty was measured with 11-point numeric rating scale. RESULTS: subjects who were uncertain whether they wanted to start treatment were more likely to prefer Role 2: "to make the final selection of my treatment after seriously considering my doctor's opinion" over Role 1 "to make the final selection about which treatment I will receive" compared to those who were certain [Adjusted OR (95% CI)=4.9 (1.7-14.5)]. Subjects who were uncertain were also more likely to prefer sharing responsibility for decision making over Role 1 compared to those who were certain [Adjusted OR (95% CI)=3.7 (1.3-10.4)]. CONCLUSIONS: certainty is associated with preferred decision styles. Physicians should ascertain their patients' levels of uncertainty and adjust their input accordingly. PRACTICE IMPLICATION: physicians should ascertain their patients' levels of uncertainty and adjust their input accordingly. Published by Elsevier Ireland Ltd.
OBJECTIVE: experts recommend that clinicians tailor their interactions according to each patient's preferred decision style. Because participation is associated with improved clinical outcomes, factors which modify preferred role should be addressed before determining the level at which patients wish to participate. The objective of this study was to determine if certainty related to initiating treatment is related to preferred role in decision making. METHODS: we conducted face-to-face interviews with 142 patients eligible for the treatment of hepatitis C. Preferred role in decision making was measured using the Control Preferences Scale and certainty was measured with 11-point numeric rating scale. RESULTS: subjects who were uncertain whether they wanted to start treatment were more likely to prefer Role 2: "to make the final selection of my treatment after seriously considering my doctor's opinion" over Role 1 "to make the final selection about which treatment I will receive" compared to those who were certain [Adjusted OR (95% CI)=4.9 (1.7-14.5)]. Subjects who were uncertain were also more likely to prefer sharing responsibility for decision making over Role 1 compared to those who were certain [Adjusted OR (95% CI)=3.7 (1.3-10.4)]. CONCLUSIONS: certainty is associated with preferred decision styles. Physicians should ascertain their patients' levels of uncertainty and adjust their input accordingly. PRACTICE IMPLICATION: physicians should ascertain their patients' levels of uncertainty and adjust their input accordingly. Published by Elsevier Ireland Ltd.
Authors: Sarah L Clever; Daniel E Ford; Lisa V Rubenstein; Kathryn M Rost; Lisa S Meredith; Cathy D Sherbourne; Nae-Yuh Wang; Jose J Arbelaez; Lisa A Cooper Journal: Med Care Date: 2006-05 Impact factor: 2.983
Authors: Michael M Ward; Saigeetha Sundaramurthy; Debra Lotstein; Thomas M Bush; C Michael Neuwelt; Richard L Street Journal: Arthritis Rheum Date: 2003-12-15
Authors: Michael W Fried; Mitchell L Shiffman; K Rajender Reddy; Coleman Smith; George Marinos; Fernando L Gonçales; Dieter Häussinger; Moises Diago; Giampiero Carosi; Daniel Dhumeaux; Antonio Craxi; Amy Lin; Joseph Hoffman; Jian Yu Journal: N Engl J Med Date: 2002-09-26 Impact factor: 91.245