Predicting the preferences for involvement in medical decision making among patients with mental disorders

• Published in: PloS one Vol. 12; no. 8; p. e0182203
• Main Authors: Michaelis, Svea, Kriston, Levente, Härter, Martin, Watzke, Birgit, Schulz, Holger, Melchior, Hanne
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 24.08.2017; Public Library of Science (PLoS)
• Subjects: Adolescent; Adult; Aged; Arthritis; Biology and Life Sciences; Bivariate analysis; Clinical decision making; Decision Making; Decisions; Demographic variables; Demographics; Effectiveness; Female; Health aspects; Humans; Male; Medicine and Health Sciences; Mental disorders; Mental Disorders - psychology; Mental Disorders - therapy; Mentally ill persons; Middle Aged; Patient Participation; Patients; People and Places; Psychological aspects; Psychotherapy; Regression analysis; Risk factors; Social Sciences; Studies; Young Adult; Germany
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0182203

The involvement of patients in medical decision making has been investigated widely in somatic diseases. However, little is known about the preferences for involvement and variables that could predict these preferences in patients with mental disorders. This study aims to determine what roles mentally ill patients actually want to assume when making medical decisions and to identify the variables that could predict this role, including patients' self-efficacy. Demographic and clinical data of 798 patients with mental disorders from three psychotherapeutic units in Germany were elicited using self-report questionnaires. Control preference was measured using the Control Preferences Scale, and patients' perceived self-efficacy was assessed using the Self-Efficacy Scale. Bivariate and multivariate regression analyses were conducted to investigate the associations between patient variables and control preference. Most patients preferred a collaborative role (57.5%), followed by a semi passive (21.2%), a partly autonomous (16.2%), an autonomous (2.8%) and a fully passive (2.3%) role when making medical decisions. Age, sex, diagnosis, employment status, medical pretreatment and perceived self-efficacy were associated with the preference for involvement in the multivariate logistic model. Our results confirm the preferences for involvement in medical decisions of mentally ill patients. We reconfirmed previous findings that older patients prefer a shared role over an autonomous role and that subjects with a high qualification prefer a more autonomous role over a shared role. The knowledge about predictors may help strengthen treatment effectiveness because matching the preferred and actual role preferences has been shown to improve clinical outcome.