a Department of Psychology , University of California , Riverside , CA , USA.
Psychol Health. 2014;29(10):1105-18. doi: 10.1080/08870446.2014.911873.
Patients' role in treatment decision-making can influence psychosocial and health-related outcomes (i.e. satisfaction, felt respect, adherence). We examined decisional control in a surgical context, identifying correlates of patients' preferences and experiences.
380 patients and 7 surgeons were surveyed during initial surgical consultation visits in a low-income outpatient clinic.
Patients reported preferences for (pre-consultation) and experiences of (post-consultation) decisional control, demographics, satisfaction with care, and adherence to treatment recommendations. Surgeons rated patients' health status.
Preferences for and experiences of decisional control were unrelated, suggesting significant preference-experience misalignment. However, this misalignment did not appear to be consequential for patient outcomes. Rather, more decisional control, regardless of patients' preferences, predicted greater satisfaction with care and greater self-reported adherence as assessed at a post-surgical appointment.
Decisional control predicts better outcomes for patients, regardless of their preferences for control over treatment decisions. These findings suggest that interventions should aim to increase patients' degree of decisional control when feasible and appropriate.
患者在治疗决策中的角色可以影响心理社会和健康相关的结果（即满意度、被尊重感、依从性）。我们在手术背景下研究了决策控制，确定了患者偏好和体验的相关因素。
380 名患者和 7 名外科医生在低收入门诊就诊的初始手术咨询期间接受了调查。
患者报告了对决策控制的偏好（咨询前）和体验（咨询后）、人口统计学、对护理的满意度和对治疗建议的依从性。外科医生评估了患者的健康状况。
偏好和体验之间的决策控制无关，表明存在显著的偏好-体验不匹配。然而，这种不匹配似乎对患者的结果没有影响。相反，无论患者的偏好如何，更多的决策控制都预示着在手术后的预约中对护理的满意度更高，自我报告的依从性更高。
无论患者对治疗决策的控制偏好如何，决策控制都可以预测患者的更好结果。这些发现表明，干预措施应旨在增加患者决策控制的程度，只要可行和适当。
