Medical information is not enough for patient’s participation in clinical decisions

  1. José Joaquin Mira 1
  2. Virtudes Pérez Jover 2
  3. Mercedes Guilabert Mora 3
  4. Susana Lorenzo 1
  1. 1 Fundación Hospital Alcorcón
    info

    Fundación Hospital Alcorcón

    Alcorcón, España

    ROR https://ror.org/01435q086

  2. 2 Universidad Miguel Hernández de Elche
    info

    Universidad Miguel Hernández de Elche

    Elche, España

    ROR https://ror.org/01azzms13

  3. 3 Centro de salud Hospital-Plá
Montrer des affiliations +
Revue:
Revista de psicología de la salud

ISSN: 2386-2300,  0214-6118

Année de publication: 2014

Volumen: 2

Número: 1

Pages: 21-41

Type: Article

DOI: 10.21134/PSSA.V2I1.511 DIALNET GOOGLE SCHOLAR lock_openAccès ouvert editor

D'autres publications dans: Revista de psicología de la salud

Objectifs de Développement Durable

Résumé

Theoretical Framework: This research was designed to analyze whether patients rate positively doctors’ attitudes and information provided favours the patient’s participation and involvement in clinical decisions. Methods: For this, we carry out a cross-sectional analysis of data on 1070 patients discharged from 7 hospitals in Spain. Results: A total of 82% referred to be satisfied with the information, of which 3% did not have the feeling that their hospital doctor had listened carefully, 27% did not have their doubts clarified, and 76% were not informed of therapeutic alternatives. When the doctor showed a receptive attitude there was actually an increase in the number of patients that still had doubts about their diagnosis and treatment (OR= 1.9, p= 0.04). Older patients were less frequently involved in clinical decisions (χ 2 = 8.05, p=0.04) and often remained with doubts (χ 2 =9.05, p=0.03). Conclusion: The conclusion is that a substantial proportion of patients seem to assume a passive role in the interaction with the doctor. There are conditions that may restrict the patient’s autonomy which do not ever affect the patient’s rating of the information provided by the doctor.

Références bibliographiques

  • Arora, N. K. y McHorney, C. (2000). Patient preferences for medical decision making: who really wants to participate? Medical Care, 38, 335-341.
  • Ashbury, F., Findlay, H., Reynolds, B. y McKerracher, K. (1998). A Canadian survey of cancer patients' experiences: are their needs being met? Journal of Pain and Symptom Management, 16, 298-306.
  • Barca, I., Parejo, R., Gutiérrez, P., Fernández, F., Alejandre, G. y López de Castro, F. (2004). La información al paciente y su participación en la toma de decisiones clínicas. Atención Primaria, 33, 361-367.
  • Beach, M. C., Duggan, P. S., Cassel, C. K. y Geller, G. (2007). What does ‘respect’ mean? Exploring the moral obligation of health professionals to respect patients. Journal of General Internal Medicine, 22, 692–695.
  • Benbassat, J., Pilpel, D. y Tidhar, M. (1998). Patients' preferences for participation in clinical decision making: A review of published surveys. Behavioral Medicine, 24, 81-88.
  • Bertakis, K. D., Roter, D. y Putnam, S. M. (1991). The relationship of physician medical interview style to patient satisfaction. The Journal of Family Practice, 32, 175-181.
  • Catrine, A., Ekman, I, y Ehnfors, M. (2008). Considering patient non-participation in health care. Health Expectations, 11, 263-271.
  • Coulter, A. y Magee, H. (2003). The European patient of the future. Maidenhead: McGraw Hill Education. Open University Press.
  • Czaja, R., Manfredi, C. y Price, J. (2003). The determinants and consequences of information seeking among cancer patients. Journal of Health Communication, 8, 529-562.
  • Dickert, N. W. y Kass, N. E. (2009). Understanding respect: learning from patients. Journal of Medical Ethics, 35, 419-423.
  • Dillon, R. (1992). Respect and care: toward moral integration. Canadian Journal of Philosophy, 22, 105–132.
  • Feldman-Stewart, D., Brundage, M. D. y McConell, B. A. (2000). Practical issues in assisting shared decision-making. Health Expectations, 3, 46-54.
  • Ford, S., Schofield, Th. y Hope, T. (2003). Are patients’ decision-making preferences being met? Health Expectations, 6, 72-80.
  • Hartzband, P. H. y Groopman, J. (2009). Keeping the Patient in the EquationHumanism and Health Care Reform. British Medical Journal, 361, 554-555.
  • Hsieh, M. y Kagle, J. D. (1991). Understanding patient satisfaction and dissatisfaction with health care. Health y Social Work, 16, 281- 290.
  • Jadad, A., Rizzo, C. y Enkin, M. (2003). I am a good patient believe it or not. British Medical Journal, 326, 1293-1294.
  • Jahng, K., Martin, L., Golin, C. y DiMatteo, M. R. (2005). Preferences for medical collaboration: patient-physician congruence and patient outcomes. Patient Education and Counselling, 57, 308-314.
  • Janssen, N. B., Oort, F. J., Fockens, P., Willems, D. L., de Haes, H. C. y Smets, E. M. (2009). Under what conditions do patients want to be informed about their risk of a complication? A vignette study. Journal of Medical Ethics, 35, 276-282.
  • Joosten, E. A., DeFuentes-Merillas, L., de Weert, G. H., Sensky, T., van der Staak, C. P. y de Jong, C. A. (2008). Systematic review of the effects of shared decisionmaking on patient satisfaction, treatment adherence and health status. Psychotherapy and Psychosomatics, 77, 219-226.
  • Lee, S. Y. y Hawkins, R. (2010). Why do patients seek and alternative channel? The effects of unmet needs on patients’ health-related internet use. Journal of Health Communication, 15, 152-166.
  • Légaré, F., Moher, D., Elwyn, G., LeBlanc, A. y Gravel, K. (2007). Instruments to assess the perception of physicians in the decision-making process of specific clinical encounters: a systematic review. BMC Medical Informatics and Decision Making, 15, 7-30.
  • Légaré, F., Ratté, S., Gravel, K. y Graham, I. D. (2008). Barriers and facilitators to implementing shared decision-making in clinical practice: update of a systematic review of health professionals' perceptions. Patient Education and Counselling, 73, 526-535.
  • Loayssa, J. R., González, F. y Ruiz, R. (2007). Teoría declarada de los médicos de familia sobre la relación con el paciente. Atención Primaria, 39, 291-297.
  • Lorenzo, S. (2008). Hacia nuevos planteamientos de calidad. El paciente como coprotagonista. Gaceta Sanitaria, 22(1), 186-191.
  • Mira, J. J., Aranaz, J. M., Vitaller, J., Ziadi, M., Lorenzo, S., Rebasa, P. y Aibar, C. (2008). Percepción de seguridad clínica tras el alta hospitalaria. Medicina Clínica, 131(3), 26-32.
  • Mira, J. J., Lorenzo, S., Pérez-Jover, V. y Ortiz, L. (2010). Listen carefully to the patient, it means more advantages than costs. Medicina Clínica, 135, 476–478.
  • Mira, J. J., Nebot, C., Lorenzo, S. y Pérez-Jover, V. (2010). Patient report on information given, consultation time and safety in primary care. Quality and Safety in Health Care, 19(5), e33. doi:10.1136/qshc.2009.037978
  • Mira, J. J. y Rodríguez-Marín, J. (2001). Análisis de las condiciones en las que los pacientes toman decisiones responsables. Medicina Clínica, 116, 104-110.
  • Mira, J. J., Tirado, S., Pérez-Jover, V. y Vitaller, J. (2004). Determinantes de la elección de hospital por parte de los pacientes. Gaceta Sanitaria, 18, 205-212.
  • Ryan, J. y Sysko, J. (2007). The contingency of patient preferences for involvement in health decision making. Health Care Management Review, 32, 30-36.
  • Schoen, C., Osborn, R., Huynh, P. T., Doty, M., Zapert, K., Peugh, J. y Davis, K. (2005). Taking the pulse of health care systems: experiences of patients with health problems in six countries. Health Affairs (Millwood), 24, 509-525.
  • Siminoff, L. A., Ravdin, S., Colabianchi, N. y Sturm, ChS. (2000). Doctor-patient communication patterns in breast cancer adjuvant therapy discussions. Health Expectations, 3, 26-36.
  • Stacey, D., Samant, R. y Bennett, C. (2008) Decision making in oncology: a review of patient decision aids to support patient participation. CA: A Cancer Journal for Clinicians, 58, 293-304.
  • Schildmann, J., Grunke, M., Kalden, J. R. y Vollmann, J. (2008). Information and participation in decision-making about treatment: a qualitative study of the perceptions and preferences of patients with rheumatoid arthritis. Journal of Medical Ethics, 34, 775-779.
  • Thompson, A. G. y Suñol, R. (1995). Expectations as determinants of patient satisfaction: concepts theory and evidence. International Journal for Quality in Health Care, 7, 127-141.
  • Williams, B. (1994). Patient satisfaction: a valid concept?. Social Science and Medicine, 38, 509-516.
La source de données: Dialnet