title: Psychiatric patients' preferences and experiences in clinical decision-making: examining concordance and correlates of patients' preferences.
abstract: OBJECTIVE
  To assess the concordance between patients' preferred role in clinical decision-making and the role they usually experience in their psychiatric consultations and to analyze the influence of socio-demographic, clinical and personality characteristics on patients' preferences.
  
  
  METHODS
  677 consecutive psychiatric outpatients were invited to participate in a cross-sectional survey and 507 accepted. Patients completed Control Preference Scale twice consecutively before consultation, one for their preferences of participation and another for the style they usually experienced until then, and locus of control and self-efficacy scales.
  
  
  RESULTS
  Sixty-three percent of psychiatric outpatients preferred a collaborative role in decision-making, 35% preferred a passive role and only a 2% an active one. A low concordance for preferred and experienced participation in medical decision-making was registered, with more than a half of patients wanting a more active role than they actually had. Age and doctors' health locus of control orientation were found to be the best correlates for participation preferences, while age and gender were for experienced. Psychiatric diagnoses registered significant differences in patients' preferences of participation but no concerning experiences.
  
  
  CONCLUSIONS
  The limited concordance between preferred and experienced roles in psychiatric patients is indicative that clinicians need to raise their sensitivity regarding patient's participation.
  
  
  CONCLUSIONS
  The assessment of patient's attribution style should be useful for psychiatrist to set objectives and priority in the communication with their patients.
authors.affiliation: Department of Internal Medicine, Dermatology and Psychiatry, University of La Laguna, San Cristóbal de La Laguna, Spain. Electronic address: cdelascuevas@gmail.com.
authors.forename: Carlos
authors.initials: C
authors.lastname: De las Cuevas
authors.affiliation: Department of Personality, Assessment and Psychological Treatments, University of La Laguna, San Cristóbal de La Laguna, Spain.
authors.forename: Wenceslao
authors.initials: W
authors.lastname: Peñate
authors.affiliation: Department of Psychiatry, University Autonoma de Madrid, Madrid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: de Rivera
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001294:Attitude to Health; D000066491:Clinical Decision-Making; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D057240:Patient Preference; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011570:Psychiatry; D012559:Schizophrenia / Q000188:drug therapy; D020377:Self Efficacy; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents
keywords: Decision-making; Experiences; Health locus of control; Preferences; Psychiatric patients