title: Information-seeking and decision-making preferences among adult orthodontic patients: an elective health care model.
abstract: OBJECTIVE
  When it comes to their own health care, adult patients traditionally demonstrate strong information-seeking desire but a somewhat lower desire to make their own treatment decisions in nonelective situations. Little is known about these desires in patients facing elective health care situations. We used the well-tested Autonomy Preferences Index (API) as a base to construct and test our elective Autonomy Preferences Index (eAPI) for both information-seeking and decision-making and analyzed demographic variables on both.
  
  
  METHODS
  The eAPI was constructed to mirror the API but uses elective scenarios rather than the API's nonelective scenarios. It was validated using cognitive interviews to determine item intent and comprehension and by Cronbach's alpha. Both the API and eAPI were distributed to 188 active-treatment patients at the Division of Orthodontics, University of Minnesota. API and eAPI items were scored using a 1 (low) to 5 (high) Likert scale of desire.
  
  
  RESULTS
  Mean information-seeking desire was universally high (>4, P < 0.001) for both API and eAPI instruments. Mean decision-making (DM) desire was universally low to moderate: API-DM = 2.84 and eAPI-DM = 2.6. Decision-making preferences for nonelective items (API-DM) decreased as the condition severity presented in the vignettes increased: mild = 2.88, moderate = 2.67 and severe = 2.21. Conversely, elective decision-making preferences (eAPI-DM) increased with increasing condition severity: mild = 2.51, moderate = 2.79 and severe = 3.18 (P < 0.001).
  
  
  CONCLUSIONS
  Adult patients have universally high information-seeking preferences and moderate to low decision-making preferences regardless of the elective or nonelective nature of their condition. However, as vignette condition severity increases, patients facing nonelective scenarios display progressively less desire for decision-making, whereas patients facing elective scenarios show progressively more decision-making desire.
authors.affiliation: Division of Orthodontics, University of Minnesota, Minneapolis, MN 55455, USA. mill0201@umn.edu
authors.forename: James R
authors.initials: JR
authors.lastname: Miller
authors.forename: Brent E
authors.initials: BE
authors.lastname: Larson
authors.forename: David
authors.initials: D
authors.lastname: Satin
authors.forename: Lindsay
authors.initials: L
authors.lastname: Schuster
mesh_terms: D000328:Adult; D000368:Aged; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009970:Orthodontics; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010358:Patient Participation; D026684:Personal Autonomy; D011795:Surveys and Questionnaires