When attitudes and beliefs get in the way of shared decision-making: a mediation analysis of participation preference

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Bibliographische Detailangaben
Hauptverfasser: Büdenbender, Björn (VerfasserIn) , Köther, Anja Kristina (VerfasserIn) , Grüne, Britta (VerfasserIn) , Michel, Maurice Stephan (VerfasserIn) , Kriegmair, Maximilian (VerfasserIn) , Alpers, Georg W. (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2023
In: Health expectations
Year: 2023, Jahrgang: 26, Heft: 2, Pages: 740-751
ISSN:1369-7625
DOI:10.1111/hex.13699
Online-Zugang:Resolving-System, kostenfrei: https://doi.org/10.1111/hex.13699
Verlag, kostenfrei: https://madoc.bib.uni-mannheim.de/63773/
Volltext
Verfasserangaben:Björn Büdenbender MSc, Anja K. Köther PhD, Britta Grüne MD, Maurice S. Michel MD, Maximilian C. Kriegmair MD, Georg W. Alpers PhD

MARC

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245 0 0 |a When attitudes and beliefs get in the way of shared decision-making  |b a mediation analysis of participation preference  |c Björn Büdenbender MSc, Anja K. Köther PhD, Britta Grüne MD, Maurice S. Michel MD, Maximilian C. Kriegmair MD, Georg W. Alpers PhD 
255 |b Introduction: Certain sociodemographic characteristics (e.g., older age) have previously been identified as barriers to patients' participation preference in shared decision-making (SDM). We aim to demonstrate that this relationship is mediated by the perceived power imbalance that manifests itself in patients' negative attitudes and beliefs about their role in decision-making. Methods: We recruited a large sample (N = 434) of outpatients with a range of urological diagnoses (42.2% urooncological). Before the medical consultation at a university hospital, patients completed the Patients' Attitudes and Beliefs Scale and the Autonomy Preference Index. We evaluated attitudes as a mediator between sociodemographic factors and participation preference in a path model. Results: We replicated associations between relevant sociodemographic factors and participation preference. Importantly, attitudes and beliefs about one's own role as a patient mediated this relationship. The mediation path model explained a substantial proportion of the variance in participation preference (27.8%). Participation preferences and attitudes did not differ for oncological and nononcological patients. Conclusion: Patients' attitudes and beliefs about their role determine whether they are willing to participate in medical decision-making. Thus, inviting patients to participate in SDM should encompass an assessment of their attitudes and beliefs. Importantly, negative attitudes may be accessible to change. Unlike stable sociodemographic characteristics, such values are promising targets for interventions to foster more active participation in SDM. 
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