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Examining the Relationship of Patients’ Attitudes and Beliefs With Their Self-Reported Level of Participation in Medical Decision-Making

Dados Bibliográficos

ID9103029
AutoresNavdeep K Arora (0000-0002-6209-7800, National Cancer Institute, autor correspondente), Neeraj K Arora, John Z Ayanian (Harvard University), Edward Guadagnoli (Harvard University)
Ano2005
Volume43
Fascículo9
Páginas865-872
Data de publicação2005-09-01
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoMedical Care (JOURNAL)
Identificadores do periódicoISSN: 0025-7079 • E-ISSN: 1537-1948
EditoraOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/01.mlr.0000173560.18607.67
PMID16116351
OpenAlexW2024274834
IdiomaEN
Citações recebidas5
Referências citadas39

OBJECTIVE: We applied constructs from the transtheoretical model (TTM) of behavior change to identify modifiable determinants of patient participation in medical decision-making. METHOD: We surveyed a convenience sample of 621 primary care patients at one Boston hospital (response rate 60.6%). With a random half of the sample, we examined the factor structure of a new Patient Attitudes and Beliefs Scale (PABS) that focused on issues about participation in medical decision-making, and with the other half we confirmed the factor structure and examined the association of patients' stage of readiness to participate in decision-making with subscales of the PABS (pros, cons, and decisional balance), self-efficacy, and trust in physician. RESULTS: Patients were classified into 4 stages: precontemplation (don't participate and don't intend to, 17.2%), contemplation (don't participate but contemplating participating, 6.9%), preparation (participate to some degree, 36.1%), and action (participate fully, 39.8%). Factor analysis of the PABS items indicated 2 factors representing pros and cons of participation. Scores on the pros increased and cons decreased significantly from precontemplation to action (P < 0.001). Significant nonlinear associations of stage of readiness with self-efficacy (P < 0.01) and trust in physician (P < 0.01) were evident; self-efficacy scores were highest for those in action whereas trust scores were highest for those in precontemplation. CONCLUSIONS: To move people from precontemplation towards action in participating in medical decision-making, interventions focusing on increasing the pros and decreasing the cons of participation may be needed. The challenge is to balance advocacy for an active patient role with individual patients' preference for participation

Clinical decision making · Family medicine · Medical decision making · MEDLINE · Patient participation · Political science · Healthcare Decision-Making and Restraints · Medicine · Palliative Care and End-of-Life Issues · Patient-Provider Communication in Healthcare · Psychology · Social Psychology

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Obras citantes distintas5
Citações por ano0,26
Intervalo de citações2007 - 2023 (17)
Velocidade de citaçãohistorical
Altamente citadoNão
Tipos de citaçãoNeutras: 5
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