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Veterans' decision-making preferences and perceived involvement in care for chronic heart failure.
Heart Lung. 2008 Nov-Dec; 37(6):440-8.HL

Abstract

BACKGROUND

Patients with heart failure require a great deal of information about their disease, but it is also important to know about their preferences for involvement in medical decision making and about factors that may influence their preferences so that patients' needs, values, and preferences can be met by clinicians.

OBJECTIVES

We assessed patients' preferred role and perceived level of involvement in medical decision making and tested the effects of patients' age and role preference on perceived involvement in medical decision making.

METHODS

We conducted a telephone survey of 90 adults being treated for heart failure by a Veterans Affairs primary care provider or cardiologist. Patients' preferred role in treatment decisions was assessed using the Control Preferences Scale. Perceptions about their involvement in decision making during the most recent clinic visit was measured using a subscale of the Perceived Involvement in Care Scale. Descriptive, correlational, and generalized linear regression analyses were conducted.

RESULTS

Most patients were elderly (mean = 70.1 years), male (94.4%), and white (85.6%), and had New York Heart Association class II disease (55.6%). Forty-three patients (47.8%) preferred a passive role in decision making, 19 patients (21.1%) preferred an active role, and 28 patients (31.1%) preferred a collaborative role. Most patients believed that their decision-making involvement was relatively passive, as indicated by a mean score of .96 (range, 0-4) on the Perceived Involvement in Care Scale decision-making subscale. Older age was associated with passive role preference (r = .263; P < .05) and less perceived involvement in decision making (r = -.279; P < .01). In addition, less perceived involvement in decision making during the last clinic visit was associated with a preference for a more passive decision-making role (r = rho.355; P < .01). Generalized linear regression analysis indicated that when patients' perceived decision-making involvement was regressed on age and patients' role preferences, age was no longer significantly associated with involvement (beta = -.196; P = .061), but that control preferences continued to exhibit an independent effect on perceived involvement in medical decision making (beta = -.341; P = .003).

CONCLUSION

The results suggest that the preferences of patients with heart failure for a more passive role in decision making may be a stronger independent predictor of patients' perceived involvement in decision making than patients' age.

Authors+Show Affiliations

Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania 15206, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18992627

Citation

Rodriguez, Keri L., et al. "Veterans' Decision-making Preferences and Perceived Involvement in Care for Chronic Heart Failure." Heart & Lung : the Journal of Critical Care, vol. 37, no. 6, 2008, pp. 440-8.
Rodriguez KL, Appelt CJ, Switzer GE, et al. Veterans' decision-making preferences and perceived involvement in care for chronic heart failure. Heart Lung. 2008;37(6):440-8.
Rodriguez, K. L., Appelt, C. J., Switzer, G. E., Sonel, A. F., & Arnold, R. M. (2008). Veterans' decision-making preferences and perceived involvement in care for chronic heart failure. Heart & Lung : the Journal of Critical Care, 37(6), 440-8. https://doi.org/10.1016/j.hrtlng.2008.02.003
Rodriguez KL, et al. Veterans' Decision-making Preferences and Perceived Involvement in Care for Chronic Heart Failure. Heart Lung. 2008 Nov-Dec;37(6):440-8. PubMed PMID: 18992627.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Veterans' decision-making preferences and perceived involvement in care for chronic heart failure. AU - Rodriguez,Keri L, AU - Appelt,Cathleen J, AU - Switzer,Galen E, AU - Sonel,Ali F, AU - Arnold,Robert M, Y1 - 2008/09/30/ PY - 2007/07/31/received PY - 2008/01/17/revised PY - 2008/02/08/accepted PY - 2008/11/11/pubmed PY - 2009/2/13/medline PY - 2008/11/11/entrez SP - 440 EP - 8 JF - Heart & lung : the journal of critical care JO - Heart Lung VL - 37 IS - 6 N2 - BACKGROUND: Patients with heart failure require a great deal of information about their disease, but it is also important to know about their preferences for involvement in medical decision making and about factors that may influence their preferences so that patients' needs, values, and preferences can be met by clinicians. OBJECTIVES: We assessed patients' preferred role and perceived level of involvement in medical decision making and tested the effects of patients' age and role preference on perceived involvement in medical decision making. METHODS: We conducted a telephone survey of 90 adults being treated for heart failure by a Veterans Affairs primary care provider or cardiologist. Patients' preferred role in treatment decisions was assessed using the Control Preferences Scale. Perceptions about their involvement in decision making during the most recent clinic visit was measured using a subscale of the Perceived Involvement in Care Scale. Descriptive, correlational, and generalized linear regression analyses were conducted. RESULTS: Most patients were elderly (mean = 70.1 years), male (94.4%), and white (85.6%), and had New York Heart Association class II disease (55.6%). Forty-three patients (47.8%) preferred a passive role in decision making, 19 patients (21.1%) preferred an active role, and 28 patients (31.1%) preferred a collaborative role. Most patients believed that their decision-making involvement was relatively passive, as indicated by a mean score of .96 (range, 0-4) on the Perceived Involvement in Care Scale decision-making subscale. Older age was associated with passive role preference (r = .263; P < .05) and less perceived involvement in decision making (r = -.279; P < .01). In addition, less perceived involvement in decision making during the last clinic visit was associated with a preference for a more passive decision-making role (r = rho.355; P < .01). Generalized linear regression analysis indicated that when patients' perceived decision-making involvement was regressed on age and patients' role preferences, age was no longer significantly associated with involvement (beta = -.196; P = .061), but that control preferences continued to exhibit an independent effect on perceived involvement in medical decision making (beta = -.341; P = .003). CONCLUSION: The results suggest that the preferences of patients with heart failure for a more passive role in decision making may be a stronger independent predictor of patients' perceived involvement in decision making than patients' age. SN - 1527-3288 UR - https://www.unboundmedicine.com/medline/citation/18992627/Veterans'_decision_making_preferences_and_perceived_involvement_in_care_for_chronic_heart_failure_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0147-9563(08)00021-6 DB - PRIME DP - Unbound Medicine ER -