title: Patients' preferences on information and involvement in decision making for gastrointestinal surgery.
abstract: BACKGROUND
  The relationship between physicians and patients has undergone important changes, and the current emancipation of patients has led to a real partnership in medical decision making. The present study aimed to assess patients' preferences on different aspects of decision making during treatment and potential complications, as well as the amount and type of preoperative information wanted before visceral surgery.
  
  
  METHODS
  This was a prospective non-randomized study based on a questionnaire given to 253 consecutive patients scheduled for elective gastrointestinal surgery.
  
  
  RESULTS
  In considering surgical complications or treatment in the intensive care unit, 64 % of patients wished to take an active role in any medical decisions. The respective figures for cardiac resuscitation and treatment limitations were 89 and 60 %. As for information, 73, 77, and 47 % of patients wish detailed information, information on a potential ICU hospitalization, and knowledge of cardiac resuscitation, respectively. Elderly and low-educated patients were significantly less interested in shared medical decision making (p = 0.003 and 0.015), and in receiving information (p = 0.03 and 0.05). Similarly, involvement of the family in decision making was significantly less important to elderly and male patients (p = 0.05 and 0.03, respectively). Neither the type of operation (minor or major) nor the severity of disease (malignancies versus non-malignancies) was a significant factor for shared decision making, information, or family involvement.
  
  
  CONCLUSIONS
  The vast majority of surgical patients clearly want to get adequate preoperative information about their disease and the planned treatment. They also consider it crucial to be involved in any kind of decision making for treatment and complications. For most patients, the family role is limited to supporting the treating physicians if the patient is unable to participate in decision making.
authors.affiliation: Department of Visceral Surgery, University Hospital of Lausanne (CHUV), 1011 Lausanne, Switzerland. Emilie.Uldry@chuv.ch
authors.forename: Emilie
authors.initials: E
authors.lastname: Uldry
authors.forename: Markus
authors.initials: M
authors.lastname: Schäfer
authors.forename: Alend
authors.initials: A
authors.lastname: Saadi
authors.forename: Valentin
authors.initials: V
authors.lastname: Rousson
authors.forename: Nicolas
authors.initials: N
authors.lastname: Demartines
mesh_terms: D000368:Aged; D013505:Digestive System Surgical Procedures; D005260:Female; D005767:Gastrointestinal Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000523:psychology; D057240:Patient Preference; D010817:Physician-Patient Relations; D011446:Prospective Studies; D011795:Surveys and Questionnaires