Family as a whole: elective surgery patients’ perception of the meaning of family involvement in decision making

Abstract

This study aimed to explore patient perception of the meaning of family involvement in elective surgery decision making in Taiwan. Informed consent is based on respecting patient autonomy. However in cultures where family plays a key role in medical decision making, a patient's perspective of family involvement has not been fully investigated. Based on a phenomenological approach, this study conducted semistructured interviews to elicit the experiences of 10 elective surgery patients in southern Taiwan who had family present during their surgery decision making. An adapted version of Colaizzi's (1978) method was used to analyse narratives. Three themes emerged from the elective surgery patients' perception of the meaning of family involvement in their surgery decision-making process: (1) Primacy of family well-being, (2) family as information broker, and (3) family as patient advocate. Patients articulated reciprocal relationships amongst family members, and they expressed overall family well-being as their ultimate concern when making their treatment decision. The essence of the elective surgery patients' perception of the meaning of family involvement in decision making was 'family as a whole'. Patients' concern for overall family well-being and their perspective that family plays a supportive role in transmitting information and acting as patient advocate during the decision-making process may both enhance and restrict individual patient autonomy. In cultures where family is central in decision making, appropriately involving the family in medical decisions should not be overlooked. Understanding and acknowledging the important roles of family in medical decision making from the patients' perspective can enable health professionals to more effectively communicate with patients and their family. Then, health professionals can empower the individual who is making the medical decision based on his or her own needs.