Preferences and experiences of chronically ill and disabled patients regarding shared decision-making: does the type of care to be decided upon matter?
OBJECTIVE
(1) To describe the importance chronically ill and disabled patients attach to involvement in decision-making when various care types are considered, and (2) to analyse the degree to which these patients are involved in shared decision-making (SDM) regarding these care types, and whether their involvement reflects the importance they attach to SDM.


METHODS
The study sample consisted of 812 chronically ill and disabled patients who experienced a situation of decision-making during the last year. Data were collected by a self-report survey in 2006 and were analysed by multilevel linear regression analyses.


RESULTS
Participants attached most importance to SDM when occupational healthcare issues were at stake, but perceived their actual involvement in these decisions as relatively low. Patients dealing with decision-making regarding medical care or home care experienced higher levels of involvement. The importance attached to SDM corresponds moderately with the actual role patients experience in the decision-making process.


CONCLUSIONS
The type of care to decide upon impacts on the importance patients attach to SDM as well as on their actual involvement in decision-making.


CONCLUSIONS
We suggest healthcare practitioners to pay attention to the preferred level of patient involvement each time a new care issue has to be decided upon.
van den Brink-Muinen
Atie
A
NIVEL (Netherlands Institute for Health Services Research), The Netherlands. a.brink-muinen@planet.nl
Spreeuwenberg
Peter
P
Rijken
Mieke
M
D000368:Aged; D002908:Chronic Disease / Q000523:psychology*; D003657:Decision Making; D003661:Decision Support Techniques; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D057240:Patient Preference; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D012720:Severity of Illness Index; D012959:Socioeconomic Factors