title: Social support plays a role in the attitude that people have towards taking an active role in medical decision-making.
abstract: BACKGROUND
  There is a growing emphasis towards including patients in medical decision-making. However, not all patients are actively involved in such decisions. Research has so far focused mainly on the influence of patient characteristics on preferences for active involvement. However, it can be argued that a patient's social context has to be taken into account as well, because social norms and resources affect behaviour. This study aims to examine the role of social resources, in the form of the availability of informational and emotional support, on the attitude towards taking an active role in medical decision-making.
  
  
  METHODS
  A questionnaire was sent to members of the Dutch Health Care Consumer Panel (response 70 %; n = 1300) in June 2013. A regression model was then used to estimate the relation between medical and lay informational support and emotional support and the attitude towards taking an active role in medical decision-making.
  
  
  RESULTS
  Availability of emotional support is positively related to the attitude towards taking an active role in medical decision-making only in people with a low level of education, not in persons with a middle and high level of education. The latter have a more positive attitude towards taking an active role in medical decision-making, irrespective of the level of emotional support available. People with better access to medical informational support have a more positive attitude towards taking an active role in medical decision-making; but no significant association was found for lay informational support.
  
  
  CONCLUSIONS
  This study shows that social resources are associated with the attitude towards taking an active role in medical decision-making. Strategies aimed at increasing patient involvement have to address this.
authors.affiliation: NIVEL, the Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN, Utrecht, The Netherlands. a.brabers@nivel.nl.
authors.forename: Anne E M
authors.initials: AE
authors.lastname: Brabers
authors.affiliation: NIVEL, the Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN, Utrecht, The Netherlands.
authors.forename: Judith D
authors.initials: JD
authors.lastname: de Jong
authors.affiliation: NIVEL, the Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN, Utrecht, The Netherlands.|Department of Sociology, Utrecht University, PO Box 80125, 3508 TC, Utrecht, The Netherlands.|Department of Human Geography, Utrecht University, PO Box 80125, 3508 TC, Utrecht, The Netherlands.
authors.forename: Peter P
authors.initials: PP
authors.lastname: Groenewegen
authors.affiliation: NIVEL, the Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN, Utrecht, The Netherlands.
authors.forename: Liset
authors.initials: L
authors.lastname: van Dijk
keywords: Medical decision-making; Patient participation; Social networks; Social support