The relative importance of patients' decisional control preferences and experiences.
OBJECTIVE
Patients' role in treatment decision-making can influence psychosocial and health-related outcomes (i.e. satisfaction, felt respect, adherence). We examined decisional control in a surgical context, identifying correlates of patients' preferences and experiences.


METHODS
380 patients and 7 surgeons were surveyed during initial surgical consultation visits in a low-income outpatient clinic.


METHODS
Patients reported preferences for (pre-consultation) and experiences of (post-consultation) decisional control, demographics, satisfaction with care, and adherence to treatment recommendations. Surgeons rated patients' health status.


RESULTS
Preferences for and experiences of decisional control were unrelated, suggesting significant preference-experience misalignment. However, this misalignment did not appear to be consequential for patient outcomes. Rather, more decisional control, regardless of patients' preferences, predicted greater satisfaction with care and greater self-reported adherence as assessed at a post-surgical appointment.


CONCLUSIONS
Decisional control predicts better outcomes for patients, regardless of their preferences for control over treatment decisions. These findings suggest that interventions should aim to increase patients' degree of decisional control when feasible and appropriate.
a Department of Psychology , University of California , Riverside , CA , USA.
Arezou
A
Ghane
Ho Phi
HP
Huynh
Sara E
SE
Andrews
Angela M
AM
Legg
Arnold
A
Tabuenca
Kate
K
Sweeny
D000328:Adult; D003657:Decision Making; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D010358:Patient Participation / Q000523:psychology*; D057240:Patient Preference / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D012017:Referral and Consultation
decisional control; patient satisfaction; shared decision-making; surgical communication