Impact of age, health locus of control and psychological co-morbidity on patients’ preferences for shared decision making in general practice

Abstract

Objective The aim of this study was to explore if patients’ preferences to be involved in decision making correlates with reasons for encounter, psychological or demographic characteristics and with the physicians’ estimation of the patients’ preferred communication styles. Methods Two hundred and thirty-four patients in general practice completed a questionnaire, which included the ‘Autonomy Preference Index’ (API), ‘health locus of control’ and ‘hospital anxiety and depression’. The physicians documented the diagnoses and estimated the patients’ preference for an autonomous, paternalistic or shared decision communication style. Results The preference for involvement varied across the reason for encounter (range 36.6–50.6), but this effect is explained by the patients’ age ( p < 0.01). The participation preferences and the external and internal health locus of control declined with age whereas depression scores rose ( p < 0.01). The physicians estimation corresponded with patient API scores ( p < 0.05). Conclusion It must be questioned if the preference for involvement is really a stable characteristic. The physicians were able to estimate the preferred communication style of their patients presumably on the basis of the patients’ age and education. Practice implications It appears that not every situation in general practice requires SDM, though different communication styles could be useful if adapted to the individual situation.