title: Patient involvement in decision-making: a cross-sectional study in a Malaysian primary care clinic.
abstract: OBJECTIVE
  Shared decision-making has been advocated as a useful model for patient management. In developing Asian countries such as Malaysia, there is a common belief that patients prefer a passive role in clinical consultation. As such, the objective of this study was to determine Malaysian patients' role preference in decision-making and the associated factors.
  
  
  METHODS
  A cross-sectional study.
  
  
  METHODS
  Study was conducted at an urban primary care clinic in Malaysia in 2012.
  
  
  METHODS
  Patients aged >21 years were chosen using systematic random sampling.
  
  
  METHODS
  Consenting patients answered a self-administered questionnaire, which included demographic data and their preferred and actual role before and after consultation. Doctors were asked to determine patients' role preference. The Control Preference Scale was used to assess patients' role preference.
  
  
  METHODS
  Prevalence of patients' preferred role in decision-making.
  
  
  RESULTS
  (1) Actual role played by the patient in decision-making. (2) Sociodemographic factors associated with patients' preferred role in decision-making. (3) Doctors' perception of patients' involvement in decision-making.
  
  
  RESULTS
  The response rate was 95.1% (470/494). Shared decision-making was preferred by 51.9% of patients, followed by passive (26.3%) and active (21.8%) roles in decision-making. Higher household income was significantly associated with autonomous role preference (p=0.018). Doctors' perception did not concur with patients' preferred role. Among patients whom doctors perceived to prefer a passive role, 73.5% preferred an autonomous role (p=0.900, κ=0.006).
  
  
  CONCLUSIONS
  The majority of patients attending the primary care clinic preferred and played an autonomous role in decision-making. Doctors underestimated patients' preference to play an autonomous role.
authors.affiliation: Department of Primary Care Medicine, University of Malaya Primary Care Research Group (UMPCRG), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Ranjini
authors.initials: R
authors.lastname: Ambigapathy
authors.affiliation: Department of Primary Care Medicine, University of Malaya Primary Care Research Group (UMPCRG), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Yook Chin
authors.identifier: http://orcid.org/0000-0003-1995-0359
authors.initials: YC
authors.lastname: Chia
authors.affiliation: Department of Primary Care Medicine, University of Malaya Primary Care Research Group (UMPCRG), 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; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006801:Humans; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D057240:Patient Preference; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000379:methods*; D014504:Urban Health; D055815:Young Adult
keywords: DECISION-MAKING; PATIENT PREFERENCE; PHYSICIAN-PATIENT RELATIONSHIP; PRIMARY CARE