Hospital patients' preferences for involvement in decision-making. A questionnaire survey of 1040 patients from a Swiss university hospital.

Abstract

Assessing patients' preferences for shared decision-making and receiving information. Cross-sectional cohort study. University Hospital in Northwest Switzerland. 1825 in-patients (mean age: 58 years, 48.7% female) were asked to participate, 1040 patients responded (59%). Proportion of positive answers to two questions depicting typical elements of shared decision-making plus a question asking for patients' information needs. These questions were embedded in a questionnaire sent to patients two weeks after discharge from the hospital, asking for perceived deficits during their hospital stay and socio-demographic characteristics. 779/947 (79.1%) agreed to the statement: "One should stick to the physician's advice even if one is not fully convinced of his ideas". 620/945 (65.6%) agreed to the statement: "It should completely be left to physicians to decide on a patient's treatment." 914/952 (96%) agreed to the statement: "Even when the news is bad the patient must be informed." Older patients and less educated patients are more likely to agree with the first two statements, patients with a non-Swiss cultural background favour the information needs statement slightly less than other patients (92.4 vs 96.7% agreement). The severity of illness had no influence on agreeing or not. However, patients who disagreed on any statement were more likely to report a lack of information from the hospital. A substantial number of patients in this study wanted the physician to take medical decisions. Yet, almost all patients wanted honest information about their health status. Health professionals have to find out to what extent an individual patient wants to be involved in decision-making.