Patient preference for involvement, experienced involvement, decisional conflict, and satisfaction with physician - a structural equation model test
Standard
Patient preference for involvement, experienced involvement, decisional conflict, and satisfaction with physician - a structural equation model test. / Hölzel, Lars P; Kriston, Levente; Härter, Martin.
In: BMC HEALTH SERV RES, Vol. 13, 01.01.2013, p. 231.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Patient preference for involvement, experienced involvement, decisional conflict, and satisfaction with physician - a structural equation model test
AU - Hölzel, Lars P
AU - Kriston, Levente
AU - Härter, Martin
PY - 2013/1/1
Y1 - 2013/1/1
N2 - BACKGROUND: A comprehensive model of the relationships among different shared decision-making related constructs and their effects on patient-relevant outcomes is largely missing. Objective of our study was the development of a model linking decision-making in medical encounters to an intermediate and a long-term endpoint. The following hypotheses were tested: physicians are more likely to involve patients who have a preference for participation and are willing to take responsibility in the medical decision-making process, increased patient involvement decreases decisional conflict, and lower decisional conflict favourably influences patient satisfaction with the physician.METHODS: This model was tested in a German primary care sample (N = 1,913). Psychometrically tested instruments were administered to assess the following: patients' preference for being involved in medical decision-making, patients' experienced involvement in medical decision-making, decisional conflict, and satisfaction with the primary care provider. Structural equation modelling was used to explore multiple associations. The model was tested and adjusted in a development sub-sample and cross-validated in a confirmatory sample. Demographic and clinical characteristics were accounted for as possible confounders.RESULTS: Local and global indexes suggested an acceptable fit between the theoretical model and the data. Increased patient involvement was strongly associated with decreased decisional conflict (standardised regression coefficient Β = -.73). Both high experienced involvement (Β = .34) and low decisional conflict (B = -.28) predicted higher satisfaction with the physician. Patients' preference for involvement was negatively associated with the experienced involvement (B = -.24).CONCLUSION: Altogether, our model could be largely corroborated by the collected empirical data except the unexpected negative association between preference for involvement and experienced involvement. Future research on the associations among different SDM-related constructs should incorporate longitudinal studies in order to strengthen the hypothesis of causal associations.
AB - BACKGROUND: A comprehensive model of the relationships among different shared decision-making related constructs and their effects on patient-relevant outcomes is largely missing. Objective of our study was the development of a model linking decision-making in medical encounters to an intermediate and a long-term endpoint. The following hypotheses were tested: physicians are more likely to involve patients who have a preference for participation and are willing to take responsibility in the medical decision-making process, increased patient involvement decreases decisional conflict, and lower decisional conflict favourably influences patient satisfaction with the physician.METHODS: This model was tested in a German primary care sample (N = 1,913). Psychometrically tested instruments were administered to assess the following: patients' preference for being involved in medical decision-making, patients' experienced involvement in medical decision-making, decisional conflict, and satisfaction with the primary care provider. Structural equation modelling was used to explore multiple associations. The model was tested and adjusted in a development sub-sample and cross-validated in a confirmatory sample. Demographic and clinical characteristics were accounted for as possible confounders.RESULTS: Local and global indexes suggested an acceptable fit between the theoretical model and the data. Increased patient involvement was strongly associated with decreased decisional conflict (standardised regression coefficient Β = -.73). Both high experienced involvement (Β = .34) and low decisional conflict (B = -.28) predicted higher satisfaction with the physician. Patients' preference for involvement was negatively associated with the experienced involvement (B = -.24).CONCLUSION: Altogether, our model could be largely corroborated by the collected empirical data except the unexpected negative association between preference for involvement and experienced involvement. Future research on the associations among different SDM-related constructs should incorporate longitudinal studies in order to strengthen the hypothesis of causal associations.
KW - Aged
KW - Aged, 80 and over
KW - Conflict (Psychology)
KW - Cross-Sectional Studies
KW - Decision Making
KW - Family Characteristics
KW - Female
KW - Germany
KW - Humans
KW - Male
KW - Middle Aged
KW - Models, Structural
KW - Patient Participation
KW - Patient Preference
KW - Patient Satisfaction
KW - Personal Autonomy
KW - Physician-Patient Relations
KW - Physicians, Family
KW - Psychometrics
KW - Quality of Life
KW - Questionnaires
KW - Socioeconomic Factors
U2 - 10.1186/1472-6963-13-231
DO - 10.1186/1472-6963-13-231
M3 - SCORING: Journal article
C2 - 23800366
VL - 13
SP - 231
JO - BMC HEALTH SERV RES
JF - BMC HEALTH SERV RES
SN - 1472-6963
ER -