Preferences of acutely ill patients for participation in medical decision-making.
OBJECTIVE
To determine patient preferences for information and for participation in decision-making, and the determinants of these preferences in patients recently admitted to an acute hospital.


METHODS
Prospective questionnaire-based study.


METHODS
Medical wards of an acute teaching hospital.


METHODS
One hundred and fifty-two consecutive acute medical inpatients, median age 74 years.


METHODS
Standardised assessment included abbreviated mental test and subjective measure of severity of illness. Patients' desire for information was assessed using a 5-point Likert scale, and their desire for a role in medical decision-making using the Degner Control of Preferences Scale.


RESULTS
Of the 152 patients, 93 (61%) favoured a passive approach to decision-making (either "leave all decisions to the doctor" or "doctor makes final decision but seriously considers my opinion." In contrast, 101 (66%) patients sought "very extensive" or "a lot" of information about their condition. No significant effects of age, sex, socio-economic group or severity of acute illness on desire for information or the Degner scale result were found. There was no agreement between patients' preferences on the Degner scale and their doctors' predictions of those preferences.


CONCLUSIONS
Acute medical inpatients want to receive a lot of information about their illness, but most prefer a relatively passive role in decision-making. The only way to determine individual patient preferences is to ask them; preferences cannot be predicted from clinical or sociodemographic data.
Wilkinson
C
C
Department of Geriatric Medicine, Merlin Park Regional Hospital, Galway, Ireland.
Khanji
M
M
Cotter
P E
PE
Dunne
O
O
O'Keeffe
S T
ST
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000523:psychology* / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires