Table of Contents
International Journal of Family Medicine
Volume 2013 (2013), Article ID 478498, 10 pages
http://dx.doi.org/10.1155/2013/478498
Research Article

Decision-Making of Older Patients in Context of the Doctor-Patient Relationship: A Typology Ranging from “Self-Determined” to “Doctor-Trusting” Patients

1Hannover Medical School, Institute for General Practice, Carl-Neuberg Street 1, 30625 Hannover, Germany
2University Medical Center Hamburg-Eppendorf, Department of Primary Medical Care, Martinistr. 52, 20246 Hamburg, Germany
3University Medical Centre Göttingen, Department of General Practice, Humboldtallee 38, 37073 Göttingen, Germany
4Hannover Medical School, Institute for Epidemiology, Public Medicine and Healthcare Systems Research, Carl-Neuberg Street 1, 30625 Hannover, Germany

Received 27 August 2012; Revised 20 March 2013; Accepted 20 March 2013

Academic Editor: Carolyn Chew-Graham

Copyright © 2013 Jennifer Wrede-Sach et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. This qualitative study aims to gain insight into the perceptions and experiences of older patients with regard to sharing health care decisions with their general practitioners. Patients and Methods. Thirty-four general practice patients (≥70 years) were asked about their preferences and experiences concerning shared decision making with their doctors using qualitative semistructured interviews. All interviews were analysed according to principles of content analysis. The resulting categories were then arranged into a classification grid to develop a typology of preferences for participating in decision-making processes. Results. Older patients generally preferred to make decisions concerning everyday life rather than medical decisions, which they preferred to leave to their doctors. We characterised eight different patient types based on four interdependent positions (self-determination, adherence, information seeking, and trust). Experiences of a good doctor-patient relationship were associated with trust, reliance on the doctor for information and decision making, and adherence. Conclusion. Owing to the varied patient decision-making types, it is not easy for doctors to anticipate the desired level of patient involvement. However, the decision matter and the self-determination of patients provide good starting points in preparing the ground for shared decision making. A good relationship with the doctor facilitates satisfying decision-making experiences.