Patient and Provider Decision-Making Experiences: A Qualitative Study

Abstract

The purpose of this qualitative descriptive study was to explore patient and provider experiences in making health care decisions. A convenience sample of primary care patients and providers was engaged in face-to-face and telephone interviews, to elicit participants’ experiences in making health care decisions. Three main themes were identified in the data: Involvement, including being in control and accepting responsibility; seeking and confirming Information; and establishing communication and negotiating trust in the patient-provider Relationship. Themes identified in the data describe the elements involved in health care decision-making, and depict the relationship between patient and provider as being central to the making of health care decisions. In addition, the subthemes of control and negotiation merit additional in-depth exploration to illuminate the implicit and explicit expressions of hierarchy in the patient-provider relationship, as this hierarchy appears to hinder efforts at sharing decisions in health care encounters.

At the intersection of trust and mistrust: A qualitative analysis of motivators and barriers to research participation at a safety‐net hospital

“…As it is known that trust in the patient‐provider relationship and one's healthcare organization is critical when making healthcare decisions, existing medical mistrust must be considered when conducting research 29,48,49 . Our findings show that trustworthiness can be built during the research process through positive experience, communication, and connection, or can be pre‐existing through a relationship with an individual, sector, or institution.…”

“…As it is known that trust in the patient‐provider relationship and one's healthcare organization is critical when making healthcare decisions, existing medical mistrust must be considered when conducting research. 29 , 48 , 49 Our findings show that trustworthiness can be built during the research process through positive experience, communication, and connection, or can be pre‐existing through a relationship with an individual, sector, or institution. Knowing the positive impact that trustworthiness can have on an individual's decision to participate in research, methods to increase trustworthiness should be considered and utilized to support increasing representation of safety‐net populations in healthcare research.…”

Labeled as “drug-seeking”: nurses use harm reduction philosophy to reflect on mending mutual distrust between healthcare workers and people who use drugs

“…Mistreatment related to drug use stigma discounts patient autonomy, human dignity, and the right to advocate for themselves—thus, often relying on a third party to confirm the person’s need for pain relief ( 20 , 22 ). Removing autonomy and individual advocacy in patient care is neglectful and constitutes an abuse of authority in healthcare—perpetuating the paternalistic structures in the healthcare system ( 46 , 47 ).…”