Patients' preferences for Shared Decision Making: Associations with Demographic Variables, Personality Characteristics and Characteristics of the Health Condition
Degree GrantorUniversity of Canterbury
Degree NameMaster of Science
Shared Decision Making (SDM) in medical consultations has received significant attention in the literature over the past 10 years. Research indicates that patients’ desire both components of SDM, information sharing and behavioural involvement, to differing degrees (Flynn, Smith, & Vanness, 2006) and that matching medical care to these preferences may be associated with better patient health outcomes (Cvengros, Christensen, Cunningham, Hillis, & Kaboli, 2009). In this thesis, relationships between SDM preferences and patients’ personal characteristics (demographic factors and personality attributes) were investigated (Objective one), as well as associations between patient’s SDM preferences and the features of the health concern that they were seeking care for (Objective two). The current study used 158 Christchurch residents who were part of a longitudinal health and wellbeing study. They completed a questionnaire that measured their general SDM preferences, their demographic and personality characteristics and their preferences for SDM, given four hypothetical health complaints. These complaints varied in duration and perceived seriousness. Demographic variables and personality variables accounted for approximately the same amount of variance in participants’ general preferences for SDM, together describing 33% and 42% of the variance in information sharing and behavioural involvement. The strongest contributors were all three Health Locus of Control variables, sex and education level. Big Five personality traits and participant self-rated physical health did not account for a significant amount of variance in SDM preferences, once all variables were controlled for. In addition, the features of the health concern were marginally associated with participants’ SDM preferences for that specific consultation. Between-subjects analyses found that the duration or perceived seriousness of the health complaint were not associated with SDM preferences reported within the first scenario, once participants’ general SDM preferences were accounted for. Whereas, these two features described a significant amount of variance in participants’ information sharing preferences in the within-subjects analyses, when participants’ general SDM preferences were controlled for. Post-hoc analyses reported that chronic health complaints, that were perceived to be highly serious, elicited significantly greater preferences for information exchange than all other scenarios. No association occurred for participants’ preferences for involvement in final decision making across the four scenarios. The findings emphasise that differences occur in patients’ preferences for information sharing and behavioural involvement; both in regard to their general preferences and their specific preferences for these components of SDM within a given consultation. They also identify the central role that patients’ personality characteristics may play in determining their collaboration and involvement in healthcare; associations that are often overlooked by the SDM literature. The current findings contribute to our understanding of patient’s preferences for SDM and implications for practice and future research are discussed.