Abstract
BackgroundNumerous studies examined factors in promoting a patient preference for active participation in treatment decision making with only modest success. The purpose of this study was to identify types of patients wishing to participate in treatment decisions as well as those wishing to play a completely active or passive role based on a Germany-wide survey of dialysis patients; using a prediction typal analysis method that defines types as configurations of categories belonging to different attributes and takes particularly higher order interactions between variables into account.MethodsAfter randomly splitting the original patient sample into two halves, an exploratory prediction configural frequency analysis (CFA) was performed on one-half of the sample (n = 1969) and the identified types were considered as hypotheses for an inferential prediction CFA for the second half (n = 1914). 144 possible prediction types were tested by using five predictor variables and control preferences as criterion. An α-adjustment (0.05) for multiple testing was performed by the Holm procedure.Results21 possible prediction types were identified as hypotheses in the exploratory prediction CFA; four patient types were confirmed in the confirmatory prediction CFA: patients preferring a passive role show low information seeking preference, above average trust in their physician, perceive their physician's participatory decision-making (PDM)-style positive, have a lower educational level, and are 56-75 years old (Type 1; p < 0.001) or > 76 years old (Type 2; p < 0.001). Patients preferring an active role show high information seeking preference, a higher educational level, and are < 55 years old. They have either below average trust, perceive the PDM-style negative (Type 3; p < 0.001) or above average trust and perceive the PDM-style positive (Type 4; p < 0.001).ConclusionsThe method prediction configural frequency analysis was newly introduced to the research field of patient participation and could demonstrate how a particular control preference role is determined by an association of five variables.
Highlights
Numerous studies examined factors in promoting a patient preference for active participation in treatment decision making with only modest success
In order to ensure that the overall study sample of 6318 patients was representative of the KfH patient population, both groups were compared with regard to their gender, age, educational level, length of their dialysis treatment, and their Karnofsky Index
The passive types always demonstrated above-average trust in their physician and a positive perception of their involvement by their physician in decision making, whereas the active types could exhibit a below-average level of trust in their physician together with a negative perception of their physician’s participatory decision-making (PDM) style (Table 3). These results are supported in parts by the reports of other researchers: multivariate studies have already shown that the desire for active participation in treatment decision-making increases in patients with a higher educational level [26,44] and a somewhat lower age [44] and tends to decrease the older the patients and the lower their educational level [54]
Summary
Numerous studies examined factors in promoting a patient preference for active participation in treatment decision making with only modest success. The purpose of this study was to identify types of patients wishing to participate in treatment decisions as well as those wishing to play a completely active or passive role based on a Germany-wide survey of dialysis patients; using a prediction typal analysis method that defines types as configurations of categories belonging to different attributes and takes higher order interactions between variables into account. Patients’ preferences for involvement in treatment decisions According to Charles and colleagues [1], there are three different models for describing patient-physician interaction. Shared decision making (SDM) has already shown to lead to improved treatment outcomes for chronically ill patients [3]. Other researchers suggest that physicians vary widely in how much they facilitate patients’ active participation in treatment decisions, what they have termed a “participatory decisionmaking style” [6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
