Optimal participation in decision-making in advanced chronic disease: perspectives of patients, relatives and physicians

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11120%2F21%3A43921263" target="_blank" >RIV/00216208:11120/21:43921263 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11110/21:10425715

Result on the web

<a href="https://doi.org/10.21037/apm-20-2368" target="_blank" >https://doi.org/10.21037/apm-20-2368</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.21037/apm-20-2368" target="_blank" >10.21037/apm-20-2368</a>

Result language

angličtina

Original language name

Optimal participation in decision-making in advanced chronic disease: perspectives of patients, relatives and physicians

Original language description

BACKGROUND: Making decisions about health care issues in advanced illness is difficult and the participation of patients and relatives is essential. Most of the studies on shared decision-making focus on the interaction between patient and physician (dyadic interaction), while the role of relatives in triadic decision-making remains less explored. The aim of the study was to investigate the perceived importance of the role of the patient, the physician and the relative in the decision-making from their respective perspectives. METHODS: Patients (n=154) with advanced disease, their relatives (n=95) and physicians (n=108) were asked to rank the importance of their roles on the scale from 0 to 10. Differences between respondent groups were examined by ANOVA. A typology of answers was constructed for dyadic and triadic relations and analyzed by descriptive statistics and the chi-square test. RESULTS: Physicians rated the importance of patients&apos; role in decision-making significantly higher [mean 9.31; 95% confidence interval (CI): 9.07-9.55] than did patients themselves (mean 7.85; 95% CI: 7.37-8.32), while patients and relatives rated higher the importance of the physicians&apos; role (mean 9.29; 95% CI: 8.98- 9.59 and mean 9.20; 95% CI: 8.96-9.45, respectively) than did physicians themselves (mean 8.35; 95% CI: 0.06-8.65). In the analysis of the patient-physician dyadic interaction, patients ranked their role as equally important (44.1%) or more important (11.2%) than the role of physicians. Physicians (56.5%) thought patients should play a more important role. When relatives were included in the analysis, patients either preferred equal role of the three actors (30.2%) or prioritized the role of the physician and the relatives (16.8%), while physicians and relatives prioritized the role of the patient (54.6% and 29.0%, respectively). All results were statistically significant (P&lt;0.05). CONCLUSIONS: Physicians and relatives tend to accentuate the active role of patients, while patients mostly prefer shared decision-making. Physicians seem to underestimate the importance of the role of relatives, compared to patients and relatives for whom the participation of relatives in the decision-making is of greater importance. A triadic decision-making model that acknowledges the importance of all three actors should be implemented in decision-making process in advanced illness.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30227 - Geriatrics and gerontology

Project

—

Continuities

V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Publication year

2021

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Annals of Palliative Medicine

ISSN

2224-5820

e-ISSN

—

Volume of the periodical

10

Issue of the periodical within the volume

4

Country of publishing house

CN - CHINA

Number of pages

9

Pages from-to

3951-3959

UT code for WoS article

000646574100029

EID of the result in the Scopus database

2-s2.0-85106539155