A Prospective Cohort Study of Medical Decision-Making Roles and Their Associations with Patient Characteristics and Patient-Reported Outcomes among Patients with Heart Failure

Semra Ozdemir, Jia Jia Lee, Khung Keong Yeo, Kheng Leng David Sim, Eric Andrew Finkelstein and Chetna Malhotra
Additional contact information
Semra Ozdemir: Signature Program in Health Services and Systems Research, Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
Jia Jia Lee: Research Associate, Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
Khung Keong Yeo: National Heart Centre Singapore, Singapore
Kheng Leng David Sim: National Heart Centre Singapore, Singapore
Eric Andrew Finkelstein: Signature Program in Health Services and Systems Research, Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
Chetna Malhotra: Signature Program in Health Services and Systems Research, Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore

Medical Decision Making, 2023, vol. 43, issue 7-8, 863-874

Abstract: Objective Among patients with heart failure (HF), we examined 1) the evolution of patient involvement in decision making over 2 y, 2) the association of patient characteristics with decision-making roles, and 3) the association of decision-making roles with distress, spiritual well-being, and quality of physician communication. Methods We administered the survey every 4 mo over 24 mo to patients with New York Heart Association class 3/4 symptoms recruited from inpatient clinics. The decision-making roles were categorized as no patient involvement, physician/family-led, joint (with family and/or physicians), patient-led, or patient-alone decision making. The associations between patient characteristics and decision-making roles were assessed using a mixed-effects ordered logistic regression, whereas those between patient outcomes and decision-making roles were investigated using mixed-effects linear regressions. Results Of the 557 patients invited, 251 participated in the study. The most common roles in decision making at baseline assessment were “no involvement†(27.53%) and “patient-alone decision making†(25.10%). The proportions of different decision-making roles did not change over 2 y ( P  = 0.37). Older age (odds ratio [OR] = 0.97; P  = 0.003) and being married (OR = 0.63; P  = 0.035) were associated with lower involvement in decision making. Chinese ethnicity (OR = 1.91; P  = 0.003), higher education (OR = 1.87; P  = 0.003), awareness of terminal condition (OR = 2.00; P  

Keywords: medical decision making; shared decision making; heart failure; distress; spiritual well-being (search for similar items in EconPapers)
Date: 2023
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://journals.sagepub.com/doi/10.1177/0272989X231201609 (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:43:y:2023:i:7-8:p:863-874

DOI: 10.1177/0272989X231201609

Access Statistics for this article

More articles in Medical Decision Making
Bibliographic data for series maintained by SAGE Publications ().