Arthritis patients' motives for (not) wanting to be involved in medical decision-making and the factors that hinder or promote patient involvement.
The aim of this study is to gain insight into arthritis patients' motives for (not) wanting to be involved in medical decision-making (MDM) and the factors that hinder or promote patient involvement. In-depth semi-structured interviews were conducted with 29 patients suffering from Rheumatoid Arthritis (RA). Many patients perceived the questions about involvement in MDM as difficult, mostly because they were unaware of having a choice. Shared decision-making (SDM) was generally preferred, but the preferred level of involvement varied between and within individuals. Preference regarding involvement may vary according to the type of treatment and the severity of the complaints. A considerable group of respondents would have liked more participation than they had experienced in the past. Perceived barriers could be divided into doctor-related (e.g. a paternalistic attitude), patient-related (e.g. lack of knowledge) and context-related (e.g. too little time to decide) factors. This study demonstrates the complexity of predicting patients' preferences regarding involvement in MDM: most RA patients prefer SDM, but their preference may vary according to the situation they are in and the extent to which they experience barriers in getting more involved. Unawareness of having a choice is still a major barrier for patient participation. The attending physician seems to have an important role as facilitator in enhancing patient participation by raising awareness and offering options, but implementing SDM is a shared responsibility; all parties need to be involved and educated.
Department of Psychology, Health and Technology, University of Twente, PO Box 217, 7500AE, Enschede, The Netherlands. i.nota@utwente.nl.
Ingrid
I
Nota
Department of Psychology, Health and Technology, University of Twente, PO Box 217, 7500AE, Enschede, The Netherlands.
Constance H C
CH
Drossaert
Department of Psychology, Health and Technology, University of Twente, PO Box 217, 7500AE, Enschede, The Netherlands.
Erik
E
Taal
Department of Psychology, Health and Technology, University of Twente, PO Box 217, 7500AE, Enschede, The Netherlands.|Department of Rheumatology and Clinical Immunology, Medisch Spectrum Twente, PO Box 50 000, 7500 KA, Enschede, The Netherlands.
Mart A F J
MA
van de Laar
D000293:Adolescent; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000523:psychology* / Q000628:therapy; D001291:Attitude of Health Personnel; D000066491:Clinical Decision-Making; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010358:Patient Participation / Q000523:psychology*; D057240:Patient Preference; D010817:Physician-Patient Relations; D055815:Young Adult
Medical decision-making; Patient involvement; Patient participation; Rheumatoid arthritis; Shared decision-making