When attitudes and beliefs get in the way of shared decision‐making: A mediation analysis of participation preference
Abstract Introduction Certain sociodemographic characteristics (e.g., older age) have previously been identified as barriers to patients' participation preference in shared decision‐making (SDM). We aim to demonstrate that this relationship is mediated by the perceived power imbalance that mani...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-04-01
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| Series: | Health Expectations |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/hex.13699 |
| _version_ | 1827991359421677568 |
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| author | Björn Büdenbender Anja K. Köther Britta Grüne Maurice S. Michel Maximilian C. Kriegmair Georg W. Alpers |
| author_facet | Björn Büdenbender Anja K. Köther Britta Grüne Maurice S. Michel Maximilian C. Kriegmair Georg W. Alpers |
| author_sort | Björn Büdenbender |
| collection | DOAJ |
| description | Abstract Introduction Certain sociodemographic characteristics (e.g., older age) have previously been identified as barriers to patients' participation preference in shared decision‐making (SDM). We aim to demonstrate that this relationship is mediated by the perceived power imbalance that manifests itself in patients' negative attitudes and beliefs about their role in decision‐making. Methods We recruited a large sample (N = 434) of outpatients with a range of urological diagnoses (42.2% urooncological). Before the medical consultation at a university hospital, patients completed the Patients' Attitudes and Beliefs Scale and the Autonomy Preference Index. We evaluated attitudes as a mediator between sociodemographic factors and participation preference in a path model. Results We replicated associations between relevant sociodemographic factors and participation preference. Importantly, attitudes and beliefs about one's own role as a patient mediated this relationship. The mediation path model explained a substantial proportion of the variance in participation preference (27.8%). Participation preferences and attitudes did not differ for oncological and nononcological patients. Conclusion Patients' attitudes and beliefs about their role determine whether they are willing to participate in medical decision‐making. Thus, inviting patients to participate in SDM should encompass an assessment of their attitudes and beliefs. Importantly, negative attitudes may be accessible to change. Unlike stable sociodemographic characteristics, such values are promising targets for interventions to foster more active participation in SDM. Patient or Public Contribution This study was part of a larger project on implementing SDM in urological practice. Several stakeholders were involved in the design, planning and conduction of this study, for example, three authors are practising urologists, and three are psychologists with experience in patient care. In addition, the survey was piloted with patients, and their feedback was integrated into the questionnaire. The data presented in this study is based on patients' responses. Results may help to empower our patients. |
| first_indexed | 2024-04-10T00:49:32Z |
| format | Article |
| id | doaj.art-35c7086d44c746c2bddd1e2f98f48fe8 |
| institution | Directory Open Access Journal |
| issn | 1369-6513 1369-7625 |
| language | English |
| last_indexed | 2024-04-10T00:49:32Z |
| publishDate | 2023-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Health Expectations |
| spelling | doaj.art-35c7086d44c746c2bddd1e2f98f48fe82023-03-13T12:33:24ZengWileyHealth Expectations1369-65131369-76252023-04-0126274075110.1111/hex.13699When attitudes and beliefs get in the way of shared decision‐making: A mediation analysis of participation preferenceBjörn Büdenbender0Anja K. Köther1Britta Grüne2Maurice S. Michel3Maximilian C. Kriegmair4Georg W. Alpers5Department of Psychology, School of Social Sciences University of Mannheim Mannheim GermanyDepartment of Psychology, School of Social Sciences University of Mannheim Mannheim GermanyDepartment of Urology and Urosurgery, University Medical Center Mannheim University of Heidelberg Mannheim GermanyDepartment of Urology and Urosurgery, University Medical Center Mannheim University of Heidelberg Mannheim GermanyDepartment of Urology and Urosurgery, University Medical Center Mannheim University of Heidelberg Mannheim GermanyDepartment of Psychology, School of Social Sciences University of Mannheim Mannheim GermanyAbstract Introduction Certain sociodemographic characteristics (e.g., older age) have previously been identified as barriers to patients' participation preference in shared decision‐making (SDM). We aim to demonstrate that this relationship is mediated by the perceived power imbalance that manifests itself in patients' negative attitudes and beliefs about their role in decision‐making. Methods We recruited a large sample (N = 434) of outpatients with a range of urological diagnoses (42.2% urooncological). Before the medical consultation at a university hospital, patients completed the Patients' Attitudes and Beliefs Scale and the Autonomy Preference Index. We evaluated attitudes as a mediator between sociodemographic factors and participation preference in a path model. Results We replicated associations between relevant sociodemographic factors and participation preference. Importantly, attitudes and beliefs about one's own role as a patient mediated this relationship. The mediation path model explained a substantial proportion of the variance in participation preference (27.8%). Participation preferences and attitudes did not differ for oncological and nononcological patients. Conclusion Patients' attitudes and beliefs about their role determine whether they are willing to participate in medical decision‐making. Thus, inviting patients to participate in SDM should encompass an assessment of their attitudes and beliefs. Importantly, negative attitudes may be accessible to change. Unlike stable sociodemographic characteristics, such values are promising targets for interventions to foster more active participation in SDM. Patient or Public Contribution This study was part of a larger project on implementing SDM in urological practice. Several stakeholders were involved in the design, planning and conduction of this study, for example, three authors are practising urologists, and three are psychologists with experience in patient care. In addition, the survey was piloted with patients, and their feedback was integrated into the questionnaire. The data presented in this study is based on patients' responses. Results may help to empower our patients.https://doi.org/10.1111/hex.13699patient attitudespatient‐centred healthcarepatient participationpatient preferencespatient‐reported barriersshared decision‐making |
| spellingShingle | Björn Büdenbender Anja K. Köther Britta Grüne Maurice S. Michel Maximilian C. Kriegmair Georg W. Alpers When attitudes and beliefs get in the way of shared decision‐making: A mediation analysis of participation preference Health Expectations patient attitudes patient‐centred healthcare patient participation patient preferences patient‐reported barriers shared decision‐making |
| title | When attitudes and beliefs get in the way of shared decision‐making: A mediation analysis of participation preference |
| title_full | When attitudes and beliefs get in the way of shared decision‐making: A mediation analysis of participation preference |
| title_fullStr | When attitudes and beliefs get in the way of shared decision‐making: A mediation analysis of participation preference |
| title_full_unstemmed | When attitudes and beliefs get in the way of shared decision‐making: A mediation analysis of participation preference |
| title_short | When attitudes and beliefs get in the way of shared decision‐making: A mediation analysis of participation preference |
| title_sort | when attitudes and beliefs get in the way of shared decision making a mediation analysis of participation preference |
| topic | patient attitudes patient‐centred healthcare patient participation patient preferences patient‐reported barriers shared decision‐making |
| url | https://doi.org/10.1111/hex.13699 |
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