title: Factors influencing decision-making role preferences: A qualitative study of Malaysian patients with type 2 diabetes during insulin initiation.
abstract: Patient decision-making role preference (DMRP) is a patient's preferred degree of control when making medical decisions. This descriptive qualitative study aimed to explore Malaysian patients' views on their DMRP. Between January 2011 and March 2012, 22 individual face-to-face in-depth interviews were conducted with patients with type 2 diabetes who were deciding about insulin initiation. The interviews were audio-recorded and analysed using a thematic approach. The age range of participants was 28-67 years old with 11 men. Ten patients preferred to make the decision themselves, six patients indicated that the clinician should make the decision and only one patient expressed a preference for a collaborative role. The following factors influenced DMRP: trust in clinicians, responsibility for diabetes care, level of knowledge and awareness, involvement of family and personal characteristics. In conclusion, the concept of shared decision-making is still alien, and a more participative communication style might help to facilitate patients' expression of DMRP.
authors.affiliation: University Malaya Primary Care Research Group, Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Yew Kong
authors.identifier: http://orcid.org/0000-0002-3034-8601
authors.initials: YK
authors.lastname: Lee
authors.affiliation: Dean's Office, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Wah Yun
authors.initials: WY
authors.lastname: Low
authors.affiliation: Department of Family Medicine, Faculty of Medicine and Health Science, Universiti Putra Malaysia, Selangor, Malaysia.
authors.forename: Ping Yein
authors.initials: PY
authors.lastname: Lee
authors.affiliation: University Malaya Primary Care Research Group, Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Chirk Jenn
authors.initials: CJ
authors.lastname: Ng
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People / Q000523:psychology*; D003657:Decision Making; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000208:ethnology / Q000523:psychology*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D057240:Patient Preference / Q000208:ethnology*
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin
keywords: diabetes mellitus; insulin; patient preference; shared decision-making; type 2