Abstract
【Objectives】This presentation describes approaches physicians use to promote active patient participation in decision-making with regard to medical care, and the provision of supportive suggestions about that care. The presentation will also focus on the autonomy preferences of chronic hemodialysis patients (i. e. decision-making and information-seeking preferences) and the factors involved in shared decision-making. 【Patients】The sample consists of 107 chronic hemodialysis patients treated as outpatients at S-Hospital and S-Clinic. 【Methods】The study was conducted using a self-administered questionnaire. Decision-making and information-seeking preferences were measured using the Autonomy Preference Index (API). A scale of the shared decision-making approach used by physicians was developed by the researchers. 【Results】Responses from the patients (n=63) were analyzed. In this series, the decision-making score was 33.3±13.2 (full score was 100), and information-seeking score was 87.8±8.2 (full score was 100). Decision-making was associated with age, occupation, and some categories of the shared decision-making approach by physicians. 【Conclusions】These findings suggest that most chronic hemodialysis patients have a high desire for information, but a low desire for decision-making. These findings also suggest, however, that a shared decision-making approach may increase patients' decision-making desire. The presentation concludes, therefore, that it might be important for the autonomy preferences of the patient for physicians to use a shared decision-making approach. The strategies used by physicians to increase patient decision-making involvement thus call for further discussion within the medical profession.
