You are seeing this message because your Web browser does not support basic Web standards. Find out more about why this message is appearing and what you can do to make your experience on this site better.


ABOUT JAMA
Advanced Search

Welcome   | My Account | E-mail Alerts | Access Rights | Sign In


  Vol. 252 No. 21, December 7, 1984 TABLE OF CONTENTS
  JAMA
  •  Online Features
  ARTICLES
 This Article
 •References
 •Full text PDF
 •Send to a friend
 • Save in My Folder
 •Save to citation manager
 •Permissions
 Citing Articles
 •Citation map
 •Citing articles on HighWire
 •Contact me when this article is cited
 Related Content
 •Similar articles in JAMA
 Social Bookmarking
  Add to CiteULike Add to Connotea Add to Del.icio.us Add to Digg Add to Reddit Add to Technorati Add to Twitter What's this?

Do Patients Want to Participate in Medical Decision Making?

William M. Strull, MD; Bernard Lo, MD; Gerald Charles, MD

JAMA. 1984;252(21):2990-2994.


Abstract

Although shared decision making by patients and clinicians has been advocated, little is known about the degree of participation in decision making that patients actually prefer or about clinicians' appreciation of these preferences. We administered questionnaires about three aspects of decision making to 210 hypertensive outpatients and to their 50 clinicians, who represented three types of medical practices. We found that 41% of patients preferred more information about hypertension; clinicians underestimated patient preferences for discussion about therapy in 29% of cases and overestimated in 11% (K=.22); and 53% of patients preferred to participate in making decisions, while clinicians believed that their patients desired to participate in 78% of cases. Many patients who preferred not to make initial therapeutic decisions did want to participate in ongoing evaluation of therapy. Thus, clinicians underestimate patients' desire for information and discussion but overestimate patients' desire to make decisions. Awareness of this discrepancy may facilitate communication and decision making.

(JAMA 1984;252:2990-2994)



Author Affiliations

From the Robert Wood Johnson Clinical Scholars Program, University of California, San Francisco, Veterans Administration Medical Center, and the Kaiser Hospital—Permanente Medical Group (Dr Strull); the Divisions of General Internal Medicine and Medical Ethics and the Institute for Health Policy Studies, University of California, San Francisco (Dr Lo); and the Health Systems and Planning Research Group, Veterans Administration Medical Center (Dr Charles), San Francisco.


Footnotes

Reprint requests to Kaiser Hospital, 4 North, 2200 O'Farrell St, San Francisco, CA 94115 (Dr Strull).



Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Balancing Science and Informed Choice in Decisions about Vertebroplasty
Weinstein
NEJM 2009;361:619-621.
FULL TEXT  

Information disclosure to terminally ill patients and their relatives: self-reported practice of Belgian clinical specialists and general practitioners
Michiels et al.
Palliat Med 2009;23:345-353.
ABSTRACT  

Changing attitudes to cardiopulmonary resuscitation in older people: a 15-year follow-up study
Cotter et al.
Age Ageing 2009;38:200-205.
ABSTRACT | FULL TEXT  

Randomised controlled trial of the effect of standard and detailed risk disclosure prior to bronchoscopy on peri-procedure anxiety and satisfaction
Uzbeck et al.
Thorax 2009;64:224-227.
ABSTRACT | FULL TEXT  

Involvement, satisfaction and unmet health care needs in patients with psoriatic arthritis
Leung et al.
Rheumatology (Oxford) 2009;48:53-56.
ABSTRACT | FULL TEXT  

Involving patients in decisions during psychiatric consultations
Goss et al.
Br. J. Psychiatry 2008;193:416-421.
ABSTRACT | FULL TEXT  

'We're just sick people, nothing else': ... factors contributing to elderly stroke patients' satisfaction with rehabilitation
Mangset et al.
Clin Rehabil 2008;22:825-835.
ABSTRACT  

Do Patients' Communication Behaviors Provide Insight into Their Preferences for Participation in Decision Making?
Hudak et al.
Med Decis Making 2008;28:385-393.
ABSTRACT  

Continuity-Structured Clinical Observations: Assessing the Multiple-Observer Evaluation in a Pediatric Resident Continuity Clinic
Zimmer et al.
Pediatrics 2008;121:e1633-e1645.
ABSTRACT | FULL TEXT  

How willing are patients to question healthcare staff on issues related to the quality and safety of their healthcare? An exploratory study
Davis et al.
Qual Saf Health Care 2008;17:90-96.
ABSTRACT | FULL TEXT  

Preferences of acutely ill patients for participation in medical decision-making
Wilkinson et al.
Qual Saf Health Care 2008;17:97-100.
ABSTRACT | FULL TEXT  

Competing norms: Canadian rural family physicians' perceptions of clinical practice guidelines and shared decision-making
Boivin et al.
J Health Serv Res Policy 2008;13:79-84.
ABSTRACT | FULL TEXT  

Improving Hypertension Control in Diabetes Mellitus: The Effects of Collaborative and Proactive Health Communication
Naik et al.
Circulation 2008;117:1361-1368.
ABSTRACT | FULL TEXT  

``It's My Body'': Does Patient Involvement in Decision Making Reduce Decisional Conflict?
Kremer et al.
Med Decis Making 2007;27:522-532.
ABSTRACT  

Are Patient Decision Aids the Best Way to Improve Clinical Decision Making? Report of the IPDAS Symposium
Holmes-Rovner et al.
Med Decis Making 2007;27:599-608.
ABSTRACT  

Participation in Medical Decision Making: The Patients' Perspective
Fraenkel and McGraw
Med Decis Making 2007;27:533-538.
ABSTRACT  

Doctors' and Patients' Preferences for Participation and Treatment in Curative Prostate Cancer Radiotherapy
Stalmeier et al.
JCO 2007;25:3096-3100.
ABSTRACT | FULL TEXT  

Evaluating Deliberation in Pediatric Primary Care
Cox et al.
Pediatrics 2007;120:e68-e77.
ABSTRACT | FULL TEXT  

The Physician-Surrogate Relationship
Torke et al.
Arch Intern Med 2007;167:1117-1121.
ABSTRACT | FULL TEXT  

Impact of the Ottawa Decision Support Framework on the Agreement and the Difference between Patients' and Physicians' Decisional Conflict
Legare et al.
Med Decis Making 2006;26:373-390.
ABSTRACT  

Volunteering for early phase gene transfer research in Parkinson disease
Kim et al.
Neurology 2006;66:1010-1015.
ABSTRACT | FULL TEXT  

A study of the factors affecting the likelihood of patients participating in a campaign to improve staff hand hygiene
Duncanson and Pearson
British Journal of Infection Control 2005;6:26-30.
ABSTRACT  

The couple's decision-making in IVF: one or two embryos at transfer?
Blennborn et al.
Hum Reprod 2005;20:1292-1297.
ABSTRACT | FULL TEXT  

Clinician-Parent Communication during Informed Consent for Pediatric Leukemia Trials
Miller et al.
J Pediatr Psychol 2005;30:219-229.
ABSTRACT | FULL TEXT  

Consultations for asthma: will greater patient involvement deliver better health?
Griffiths
Thorax 2005;60:177-178.
FULL TEXT  

A helping hand: providing information to patients and the public
Dosani
Psychiatr. Bull. 2005;29:1-2.
FULL TEXT  

Decision Aids for Benign Prostatic Hyperplasia: Applicability across Race and Education
Rovner et al.
Med Decis Making 2004;24:359-366.
ABSTRACT  

Modeling Patients' Acceptance of Provider-delivered E-health
Wilson and Lankton
J. Am. Med. Inform. Assoc. 2004;11:241-248.
ABSTRACT | FULL TEXT  

A Patient-Centered Model of Care for Hospital Discharge
Anthony and Hudson-Barr
Clin Nurs Res 2004;13:117-136.
ABSTRACT  

African American Patients' Perspectives on Medical Decision Making
Torke et al.
Arch Intern Med 2004;164:525-530.
ABSTRACT | FULL TEXT  

Decisional Attributes of Patients With Diabetes: The aspirin choice
Montori et al.
Diabetes Care 2003;26:2804-2809.
ABSTRACT | FULL TEXT  

The importance of patient preferences in treatment decisions--challenges for doctors
Say and Thomson
BMJ 2003;327:542-545.
FULL TEXT  

Validation of a Decision Regret Scale
Brehaut et al.
Med Decis Making 2003;23:281-292.
ABSTRACT  

What do patients value in their hospital care? An empirical perspective on autonomy centred bioethics
Joffe et al.
J. Med. Ethics 2003;29:103-108.
ABSTRACT | FULL TEXT  

Individualizing Treatment Decisions: The Likelihood of Being Helped or Harmed
Straus
Eval Health Prof 2002;25:210-224.
ABSTRACT  

The Role of Physicians' Recommendations in Medical Treatment Decisions
Gurmankin et al.
Med Decis Making 2002;22:262-271.
ABSTRACT  

"What Should I Do, Doc?": Some Psychologic Benefits of Physician Recommendations
Ubel
Arch Intern Med 2002;162:977-980.
FULL TEXT  

Randomized Controlled Trial of a Patient Decision Aid for Colorectal Cancer Screening
Dolan and Frisina
Med Decis Making 2002;22:125-139.
ABSTRACT  

Treatment Decision Making in Early-Stage Breast Cancer: Should Surgeons Match Patients' Desired Level of Involvement?
Keating et al.
JCO 2002;20:1473-1479.
ABSTRACT | FULL TEXT  

When the Treatment Goal Is Not Cure: Are Cancer Patients Equipped to Make Informed Decisions?
Gattellari et al.
JCO 2002;20:503-513.
ABSTRACT | FULL TEXT  

Health Decision Aids To Facilitate Shared Decision Making in Office Practice
Barry
ANN INTERN MED 2002;136:127-135.
ABSTRACT | FULL TEXT  

Enhancing Physician-Patient Communication
Lee et al.
ASH Education Book 2002;2002:464-483.
ABSTRACT | FULL TEXT  

A Diabetes-Specific Measure of Patient Desire to Participate in Medical Decision Making
Golin et al.
The Diabetes Educator 2001;27:875-886.
ABSTRACT  

Variability in patient preferences for participating in medical decision making: implication for the use of decision support tools
Robinson and Thomson
Qual Saf Health Care 2001;10:i34-38.
ABSTRACT | FULL TEXT  

Older patients' experiences of pre-treatment discussions: An analysis of qualitative data from a study of colorectal cancer
Bailer
Journal of Research in Nursing 2001;6:736-746.
ABSTRACT  

The Effect of Unmet Expectations among Adults Presenting with Physical Symptoms
Jackson and Kroenke
ANN INTERN MED 2001;134:889-897.
ABSTRACT | FULL TEXT  

Discussing Adjuvant Cancer Therapy
Leighl et al.
JCO 2001;19:1768-1778.
ABSTRACT | FULL TEXT  

How Much Information About Adverse Effects of Medication Do Patients Want From Physicians?
Ziegler et al.
Arch Intern Med 2001;161:706-713.
ABSTRACT | FULL TEXT  

Do Patients Want Control over their Own Health Care? A Review of Measures, Findings, and Research Issues
Auerbach
J Health Psychol 2001;6:191-203.
ABSTRACT  

End-of-Life Conversations: Evolving Practice and Theory
Larson and Tobin
JAMA 2000;284:1573-1578.
ABSTRACT | FULL TEXT  

An entrustment model of consent for surgical treatment of life-threatening illness: Perspective of patients requiring esophagectomy
McKneally and Martin
J. Thorac. Cardiovasc. Surg. 2000;120:264-269.
ABSTRACT | FULL TEXT  

Use of Complementary/Alternative Medicine by Breast Cancer Survivors in Ontario: Prevalence and Perceptions
Boon et al.
JCO 2000;18:2515-2521.
ABSTRACT | FULL TEXT  

Users' Guides to the Medical Literature: XX. Integrating Research Evidence With the Care of the Individual Patient
McAlister et al.
JAMA 2000;283:2829-2836.
ABSTRACT | FULL TEXT  

Informed Proxy Consent: Communication Between Pediatric Surgeons and Surrogates About Surgery
Lashley et al.
Pediatrics 2000;105:591-597.
ABSTRACT | FULL TEXT  

Interpretive Review : Feasibility and Effects of Decision Aids
Molenaar et al.
Med Decis Making 2000;20:112-127.
ABSTRACT  

The Effects of Patient Communication Skills Training on Compliance
Cegala et al.
Arch Fam Med 2000;9:57-64.
ABSTRACT | FULL TEXT  

Informed Decision Making in Outpatient Practice: Time to Get Back to Basics
Braddock III et al.
JAMA 1999;282:2313-2320.
ABSTRACT | FULL TEXT  

Framework for teaching and learning informed shared decision making • Commentary: Competencies for informed shared decision making • Commentary: Proposals based on too many assumptions
Towle et al.
BMJ 1999;319:766-771.
FULL TEXT  

Evaluation of a Shared Decision Making Program for Women Suspected to Have a Genetic Predisposition to Breast Cancer: Preliminary Results
Stalmeier et al.
Med Decis Making 1999;19:230-241.
ABSTRACT  

A Survey of Gynecologists' Attitudes Regarding Decision Making in the Management of Non-cancerous Conditions That Frequently Result in Hysterectomy
Dolan and Howard
Med Decis Making 1999;19:186-192.
ABSTRACT  

Sharing decisions with patients: is the information good enough?
Coulter et al.
BMJ 1999;318:318-322.
FULL TEXT  

Decision Aids for Patients Considering Options Affecting Cancer Outcomes: Evidence of Efficacy and Policy Implications
O'Connor et al.
J Natl Cancer Inst Monogr 1999;1999:67-80.
ABSTRACT | FULL TEXT  

Preserving Scientific Debate and Patient Choice: Lessons From the Consensus Panel on Mammography Screening
Woolf and Lawrence
JAMA 1997;278:2105-2108.
ABSTRACT  

What Role Do Patients Wish to Play in Treatment Decision Making?
Deber et al.
Arch Intern Med 1996;156:1414-1420.
ABSTRACT  

The SUPPORT Project and Improving Care for Seriously III Patients
Prendergast
JAMA 1996;275:1227-1227.
ABSTRACT  

The Discussion About Advance Directives: Patient and Physician Opinions Regarding When and How It Should Be Conducted
Johnston et al.
Arch Intern Med 1995;155:1025-1030.
ABSTRACT  

Cancer Patients' Decision Making and Trial-entry Preferences: The Effects of "Framing" Information about Short-term Toxicity and Long-term Survival
Llewellyn-Thomas et al.
Med Decis Making 1995;15:4-12.
ABSTRACT  

Matching Physician Practice Style to Patient Informational Issues and Decision-Making Preferences: An Approach to Patient Autonomy and Medical Paternalism Issues in Clinical Practice
Peters
Arch Fam Med 1994;3:760-763.
ABSTRACT  

Effects of Vaccine Information Pamphlets on Parents' Attitudes
Lieu et al.
Arch Pediatr Adolesc Med 1994;148:921-925.
ABSTRACT  

Anticipated Changes in the Doctor-Patient Relationship in the Managed Care and Managed Competition of the Health Security Act of 1993
Puma
Arch Fam Med 1994;3:665-671.
ABSTRACT  

Enriching the Doctor-Patient Relationship by Inviting the Patient's Perspective
Delbanco
ANN INTERN MED 1992;116:414-418.
ABSTRACT  

Informed Consent for Colonoscopy: A Prospective Study
Mark and Spiro
Arch Intern Med 1990;150:777-780.
ABSTRACT  

Science, Ethics, and the Making of Clinical Decisions: Implications for Risk Factor Intervention
Forrow et al.
JAMA 1988;259:3161-3167.
ABSTRACT  





HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | SUBMIT | SUBSCRIBE | HELP
CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP
 
© 1984 American Medical Association. All Rights Reserved.