Do Patients Want Control over their Own Health Care? A Review of Measures, Findings, and Research Issues

Abstract

Across a wide variety of medical settings, patients report that they want detailed information about their condition and their treatment whereas stated desire for input into decision making is skewed more in the direction of physician-only or at least collaborative decision-making. These results, along with the contextual and individual difference factors associated with increased willingness to relinquish control (lower educational level, more serious illness, increasing age), indicate that patients want to assume control if they feel it will be beneficial to them to do so. The findings, however, are based largely on the relationship of patients' mean scores to arbitrarily determined scale midpoints on measures with little or no criterion-related validity. These measures also show insufficient overlap with better validated measures of desire for health care control, which indicate more normally distributed scores and a broader range of individual differences among respondents. Findings are discussed in terms of the need for further research on the structure (dimensionality) and stability of the construct desire for health care control and issues involved in conducting needed criterion-related validational work.

Does physician–patient communication that aims at empowering patients improve clinical outcome?

“…Empowerment may only be a lip-service with a traditional paternalistic attitude and practice behind it [22]. Or empowerment may not be the actual wish of the patients [23]. Or empowerment is better conducted by direct focus on patient behaviour than by improving provider-patient interaction [24].…”

Shared Decision-Making and Evidence-Based Practice

“…According to current medical models of chronic illness, the practitioner serves as the client's guide in making informed choices about living with illness and making an optimal adaptation, in terms of selfmanagement, functioning, and quality of life. Participating in making health care decisions is assumed to increase the client's engagement, knowledge, confidence, skills, and commitment to making an optimal adjustment (Auerbach, 2001).…”

Oncology professionals and patient requests for cancer support services

“…Yet, over the past 3 decades, the literature has consistently identified that many patients and family members are dissatisfied with cancer education [7]. One of the challenges for cancer education is that patients want more detailed information about their particular type of cancer and other cancer-related issues [2]. Information about treatment options, potential side effects, recovery time, and other cancer-related issues are important aspects of illness that vary considerably depending on cancer type, phase, and prognosis.…”