BMC Med Inform Decis Mak - Congruence between patients' preferred and perceived participation in medical decision-making: a review of the literature.

Tópicos

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Resumo

CKGROUND: Patients are increasingly expected and asked to be involved in health care decisions. In this decision-making process, preferences for participation are important. In this systematic review we aim to provide an overview the literature related to the congruence between patients' preferences and their perceived participation in medical decision-making. We also explore the direction of mismatched and outline factors associated with congruence.METHODS: A systematic review was performed on patient participation in medical decision-making. Medline, PsycINFO, CINAHL, EMBASE and the Cochrane Library databases up to September 2012, were searched and all studies were rigorously critically appraised. In total 44 papers were included, they sampled contained 52 different patient samples.RESULTS: Mean of congruence between preference for and perceived participation in decision-making was 60% (49 and 70 representing 25th and 75th percentiles). If no congruence was found, of 36 patient samples most patients preferred more involvement and of 9 patient samples most patients preferred less involvement. Factors associated with preferences the most investigated were age and educational level. Younger patients preferred more often an active or shared role as did higher educated patients.CONCLUSION: This review suggests that a similar approach to all patients is not likely to meet patients' wishes, since preferences for participation vary among patients. Health care professionals should be sensitive to patients individual preferences and communicate about patients' participation wishes on a regular basis during their illness trajectory.

Resumo Limpo

ckground patient increas expect ask involv health care decis decisionmak process prefer particip import systemat review aim provid overview literatur relat congruenc patient prefer perceiv particip medic decisionmak also explor direct mismatch outlin factor associ congruencemethod systemat review perform patient particip medic decisionmak medlin psycinfo cinahl embas cochran librari databas septemb search studi rigor critic apprais total paper includ sampl contain differ patient samplesresult mean congruenc prefer perceiv particip decisionmak repres th th percentil congruenc found patient sampl patient prefer involv patient sampl patient prefer less involv factor associ prefer investig age educ level younger patient prefer often activ share role higher educ patientsconclus review suggest similar approach patient like meet patient wish sinc prefer particip vari among patient health care profession sensit patient individu prefer communic patient particip wish regular basi ill trajectori

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