Patient Preferred and Perceived Control in Dental Care Decision Making.

Abstract

Shared decision making is increasingly considered the most desirable model for making decisions in medical and dental settings. It supports patients by empowering them to play an active role in the decision-making process. However, dental patients' involvement needs and perceptions have not yet been sufficiently assessed. The aim of this study was to assess patients' preferred roles in decision making for a range of dental treatments and whether patients' preferences are being met. Based on a cross-sectional study design, dental patients' autonomy preferences and actual perceived roles were surveyed in the context of existing dental appointments in a consecutive sample of 101 adult dental patients (aged 20 to 79 y). The questionnaire for the assessment of patient preferred and perceived roles in dental decision making consisted of 14 items, each representing a decision in the broad spectrum of preventive and restorative dental treatment planning, and was administered before the dental appointment and immediately afterward. Responses for each item were indicated on an ordinal 5-point scale, which was adapted from the Control Preference Scale. Differences in overall levels of control and responses for each decision were tested for statistical significance per the Wilcoxon matched-pairs signed-rank test. Furthermore, a multilevel mixed effects linear regression model was computed. Patients rated their preferred role in decision making more active and involved than their perceived role. This effect was observed and statistically significant ( P < 0.05) for 11 of 14 treatment decisions. Perceived roles (follow-up) matched the preferred roles (baseline) for less than half of patients. None of the sociodemographic characteristics had a substantial statistical effect on whether perceived roles matched the preferred roles. Dental patients' perceived roles in decision making do not meet their preferences. Dentists should allow and encourage their patients to be more active in decision making. Since dental patients' perceived roles in decision making do not meet their preferences, clinicians should encourage and enable their dental patients to fulfill the role in decision making that they prefer. This may help in the future to not only fulfill the right of patients to be informed but also empower them to play an active role in the decision-making process and reduce the risk of decisional conflicts.