Texas A&M University, USA.
University of Bielefeld, Germany.
Soc Sci Med. 2022 May;301:114932. doi: 10.1016/j.socscimed.2022.114932. Epub 2022 Mar 26.
In 2018, Alden et al. showed that the desired degree of family involvement in medical decisions is an individual preference that is largely independent from East-West cultural stereotypes. At the same time, individual-level interdependence influenced whether patients preferred more individual or more family involvement in their decision making together with their medical care provider. The present study provides empirical evidence and adds evidence for Europe for which no such data previously existed.
The present study is a direct replication and extension of the original Alden et al. (2018) study (N = 2031; Australia, China, Malaysia, India, South Korea, Thailand, United States [U.S.]), however, using survey data from four European countries (Austria, Belgium, Germany, Netherlands) and the United States (U.S.) with a total sample size of N = 2750.
Random effects within-between models replicated the original primary finding that those with higher self-involvement in medical decision making preferred less family involvement. Furthermore, patients with lower self-independence, higher relational interdependence, and stronger beliefs in social hierarchy are more likely to want their families involved in medical decisions besides their health care provider.
These observed relationships are largely consistent both within and across the four European countries and the U.S. In conclusion, the results point to the importance of avoiding cultural stereotypes and instead, recognizing that patient desires for family involvement in medical decision making vary dramatically within cultures depending on multiple individual differences. Furthermore, a growing body of evidence suggests that these antecedents of family involvement as well as the construct itself may be measurable in diverse cultures with high levels of confidence in their reliability and validity.
2018 年，Alden 等人表明，患者希望在医疗决策中获得的家庭参与度是一种个人偏好，在很大程度上独立于东西方文化刻板印象。同时，个体层面的相互依存关系影响了患者是否更希望在与医疗保健提供者共同做出决策时，个人或家庭更多地参与决策。本研究提供了实证证据，并为欧洲提供了证据，因为之前欧洲没有此类数据。
本研究是对 Alden 等人（2018 年）原始研究的直接复制和扩展（N=2031；澳大利亚、中国、马来西亚、印度、韩国、泰国、美国），但使用了来自四个欧洲国家（奥地利、比利时、德国、荷兰）和美国（N=2750）的调查数据。
随机效应在个体间模型中复制了原始的主要发现，即那些在医疗决策中自我参与程度较高的人更喜欢较少的家庭参与。此外，自我独立性较低、关系相互依存度较高、以及更相信社会等级制度的患者，除了他们的医疗保健提供者之外，更希望他们的家人参与医疗决策。
这些观察到的关系在四个欧洲国家和美国内部和之间基本一致。总之，结果表明避免文化刻板印象的重要性，而是要认识到，患者对家庭参与医疗决策的愿望在不同文化中因多种个体差异而有很大差异。此外，越来越多的证据表明，家庭参与的这些前提以及该构念本身可以在具有高度可靠性和有效性置信度的多种文化中进行测量。
