Predicting the preferences for involvement in medical decision making among patients with mental disorders
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Predicting the preferences for involvement in medical decision making among patients with mental disorders. / Michaelis, Svea; Kriston, Levente; Härter, Martin; Watzke, Birgit; Schulz, Holger; Melchior, Hanne.
In: PLOS ONE, Vol. 12, No. 8, 2017, p. e0182203.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Predicting the preferences for involvement in medical decision making among patients with mental disorders
AU - Michaelis, Svea
AU - Kriston, Levente
AU - Härter, Martin
AU - Watzke, Birgit
AU - Schulz, Holger
AU - Melchior, Hanne
N1 - Svea Michaelis gehört zum Institut und Poliklinik für Medizinische Psychologie
PY - 2017
Y1 - 2017
N2 - BACKGROUND: The involvement of patients in medical decision making has been investigated widely in somatic diseases. However, little is known about the preferences for involvement and variables that could predict these preferences in patients with mental disorders.OBJECTIVE: This study aims to determine what roles mentally ill patients actually want to assume when making medical decisions and to identify the variables that could predict this role, including patients' self-efficacy.METHOD: Demographic and clinical data of 798 patients with mental disorders from three psychotherapeutic units in Germany were elicited using self-report questionnaires. Control preference was measured using the Control Preferences Scale, and patients' perceived self-efficacy was assessed using the Self-Efficacy Scale. Bivariate and multivariate regression analyses were conducted to investigate the associations between patient variables and control preference.RESULTS: Most patients preferred a collaborative role (57.5%), followed by a semi passive (21.2%), a partly autonomous (16.2%), an autonomous (2.8%) and a fully passive (2.3%) role when making medical decisions. Age, sex, diagnosis, employment status, medical pretreatment and perceived self-efficacy were associated with the preference for involvement in the multivariate logistic model.CONCLUSION: Our results confirm the preferences for involvement in medical decisions of mentally ill patients. We reconfirmed previous findings that older patients prefer a shared role over an autonomous role and that subjects with a high qualification prefer a more autonomous role over a shared role. The knowledge about predictors may help strengthen treatment effectiveness because matching the preferred and actual role preferences has been shown to improve clinical outcome.
AB - BACKGROUND: The involvement of patients in medical decision making has been investigated widely in somatic diseases. However, little is known about the preferences for involvement and variables that could predict these preferences in patients with mental disorders.OBJECTIVE: This study aims to determine what roles mentally ill patients actually want to assume when making medical decisions and to identify the variables that could predict this role, including patients' self-efficacy.METHOD: Demographic and clinical data of 798 patients with mental disorders from three psychotherapeutic units in Germany were elicited using self-report questionnaires. Control preference was measured using the Control Preferences Scale, and patients' perceived self-efficacy was assessed using the Self-Efficacy Scale. Bivariate and multivariate regression analyses were conducted to investigate the associations between patient variables and control preference.RESULTS: Most patients preferred a collaborative role (57.5%), followed by a semi passive (21.2%), a partly autonomous (16.2%), an autonomous (2.8%) and a fully passive (2.3%) role when making medical decisions. Age, sex, diagnosis, employment status, medical pretreatment and perceived self-efficacy were associated with the preference for involvement in the multivariate logistic model.CONCLUSION: Our results confirm the preferences for involvement in medical decisions of mentally ill patients. We reconfirmed previous findings that older patients prefer a shared role over an autonomous role and that subjects with a high qualification prefer a more autonomous role over a shared role. The knowledge about predictors may help strengthen treatment effectiveness because matching the preferred and actual role preferences has been shown to improve clinical outcome.
KW - Adolescent
KW - Adult
KW - Aged
KW - Decision Making
KW - Female
KW - Humans
KW - Male
KW - Mental Disorders
KW - Middle Aged
KW - Patient Participation
KW - Young Adult
KW - Journal Article
U2 - 10.1371/journal.pone.0182203
DO - 10.1371/journal.pone.0182203
M3 - SCORING: Journal article
C2 - 28837621
VL - 12
SP - e0182203
JO - PLOS ONE
JF - PLOS ONE
SN - 1932-6203
IS - 8
ER -