Patient autonomy and informed consent--individual preferences of senior study participants in Germany.
The majority of therapeutic decision-making takes place between therapists and elderly people. The present study sought to determine the individual preferences of elderly people in the therapist-patient interaction. From October 2010 to January 2011, data from elderly students (n = 297, mean age  > 60) were collected at three different university sites in Germany (Halle-Wittenberg, Cologne and Munich). The study used a structured questionnaire. Younger students (n = 182, mean age = 20.5) at the University of Halle-Wittenberg were questioned as well, in order to show age-specific differences. None of the participants was hospitalised. At the University of Munich, elderly students (n = 42) were given interaction-skill training for patients prior to taking part in the study. The effect of the intervention was measured in the study. Elderly participants and especially those with higher morbidity and a poorer state of information about their state of health refused to get involved in the process of medical decision-making. A group of elderly participants who received special interaction-skill training for patients afterwards preferred an equal therapist-patient relationship as well as shared decision-making. Younger participants favored an informative-participative interaction. The guidelines of therapeutic decision-making that are applied in practise do not always meet the individual needs of the elderly. Interaction-skill training for patients has great potential to both: encourage patients to get involved in the process of medical decision-making and to assume more autonomy. Hence, the aim should be to compound autonomy-empowerment and interaction-skill training for elderly people.
Institute for History and Ethics of Medicine, Martin-Luther-Universität Halle-Wittenberg, Magdeburgerstrasse 8, 06097 Haale (Saale), Germany. wolfgang.strube@med.uni-halle.de
Wolfgang
W
Strube
Florian
F
Steger
D000368:Aged; D000369:Aged, 80 and over; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007258:Informed Consent / Q000706:statistics & numerical data*; D010358:Patient Participation / Q000706:statistics & numerical data*; D057240:Patient Preference / Q000706:statistics & numerical data*; D026684:Personal Autonomy; D010817:Physician-Patient Relations; D011795:Surveys and Questionnaires