Predicting decisional conflict: Anxiety and depression in shared decision making

Köther, Anja K.; Alpers, Georg W.; Büdenbender, Björn; Lenhart, Maximilian; Michel, Maurice Stephan; Kriegmair, Maximilian C.

doi:10.1016/j.pec.2020.10.037

Cited by 30 publications

(27 citation statements)

References 42 publications

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“…Patients in our sample reported a high rate of clinical anxiety, which replicated previous findings with uro‐oncological patients 7 . High levels of anxiety may drive the motivation to be engaged in SDM for specific decisions relevant to the patient.…”

Section: Discussionsupporting

confidence: 85%

Different patients, different preferences: A multicenter assessment of patients' personality traits and anxiety in shared decision making

et al. 2022

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Objective Patient‐centered care and shared decision making (SDM) are generally recognized as the gold standard for medical consultations, especially for preference‐sensitive decisions. However, little is known about psychological patient characteristics that influence patient‐reported preferences. We set out to explore the role of personality and anxiety for a preference‐sensitive decision in bladder cancer patients (choice of urinary diversion, UD) and to determine if anxiety predicts patients' participation preferences. Methods We recruited a sample of bladder cancer patients (N = 180, primarily male, retired) who awaited a medical consultation on radical cystectomy and their choice of UD. We asked patients to fill in a set of self‐report questionnaires before this consultation, including measures of treatment preference, personality (BFI‐10), anxiety (STAI), and participation preference (API and API‐Uro), as well as sociodemographic characteristics. Results Most patients (79%) indicated a clear preference for one of the treatment options (44% continent UD, 34% incontinent UD). Patients who reported more conscientiousness were more likely to prefer more complex methods (continent UD). The majority (62%) preferred to delegate decision making to healthcare professionals. A substantial number of patients reported elevated anxiety (32%), and more anxiety was predictive of higher participation preference, specifically for uro‐oncological decisions (β = 0.207, p < 0.01). Conclusions Our findings provide insight into the role of psychological patient characteristics for SDM. Aspects of personality such as conscientiousness influence treatment preferences. Anxiety contributes to patients' motivation to be involved in pertinent decisions. Thus, personality and negative affect should be considered to improve SDM.

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Section: Discussionsupporting

confidence: 85%

Different patients, different preferences: A multicenter assessment of patients' personality traits and anxiety in shared decision making

et al. 2022

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“…14,15 In general, anxiety can impair decision making and alter the perception of risks. [16][17][18][19] Consequently, emotional distress can influence decision outcomes 20,21 and may even impede SDM.…”

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confidence: 99%

Shared Decision Making during the COVID-19 Pandemic

2021

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Objective The COVID-19 pandemic pushed some of the most well-developed health care systems to their limits. In many cases, this has challenged patient-centered care. We set out to examine individuals’ attitudes toward shared decision making (SDM) and to identify predictors of participation preference during the pandemic. Methods We conducted an online survey with a large convenience sample ( N = 1061). Our main measures of interest were participants’ generic and COVID-19–related participation preference as well as their acceptance and distress regarding a triage vignette. We also assessed anxiety, e-health literacy, and aspects of participants’ health. We conducted group comparisons and multiple linear regression analyses on participation preference as well as triage acceptance. Results In generic decision making, most participants expressed a strong need for information and a moderate participation preference. In the hypothetical case of COVID-19 infection, most preferred physician-led decisions. Generic participation preference was the strongest predictor of COVID-19–related participation preference, followed by age, education, and anxiety. Furthermore, both higher generic and COVID-19–related participation preferences predicted lower triage acceptance. Conclusion Our findings demonstrate potential health care recipients’ attitudes toward SDM during a severe health care crisis and emphasize that participation preference varies according to the context.

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“…A second major factor to impact the decision‐making process was anxiety. It is recognized that increased levels of anxiety and distress can negatively affect the decision‐making process, presenting challenges for obtaining medical information and processing it in a way, that is, consistent with one's values and preferences 20,21 . Studies have shown that pregnant patients frequently experience anxiety and uncertainty during prenatal genetic testing 13,22,23 .…”

Section: Discussionmentioning

confidence: 99%

“…It is recognized that increased levels of anxiety and distress can negatively affect the decision-making process, presenting challenges for obtaining medical information and processing it in a way, that is, consistent with one's values and preferences. 20,21 Studies have shown that pregnant patients frequently experience anxiety and uncertainty during prenatal genetic testing. 13,22,23 Yet, the COVID-19 pandemic has provoked a series of other concerns for pregnant women considering prenatal genetic testing, sources of anxiety that have not been fully identified with past infectious disease threats.…”

Section: Discussionmentioning

confidence: 99%

The impact of the emergence of COVID‐19 on women's prenatal genetic testing decisions

et al. 2021

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We conducted a study to examine the impact of COVID on patients' access and utilization of prenatal genetic screens and diagnostic tests at the onset of the COVID-19 pandemic in the U.S. Methods: We conducted telephone interviews with 40 patients to examine how the pandemic affected prenatal genetic screening and diagnostic testing decisions during the initial months of the pandemic in the U.S. An interview guide queried experiences with the ability to access information about prenatal genetic testing options and to utilize the tests when desired. Audio-recordings were transcribed and coded using NVivo 12. Analysis was conducted using Grounded Theory. Results: The pandemic did not alter most participants' decisions to undergo prenatal genetic testing. Yet, it did impact how participants viewed the risks and benefits of testing and timing of testing. There was heightened anxiety among those who underwent testing, stemming from the risk of viral exposure and the fear of being alone if pregnancy loss or fetal abnormality was identified at the time of an ultrasound-based procedure.

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Predicting decisional conflict: Anxiety and depression in shared decision making

Cited by 30 publications

References 42 publications

Different patients, different preferences: A multicenter assessment of patients' personality traits and anxiety in shared decision making

Different patients, different preferences: A multicenter assessment of patients' personality traits and anxiety in shared decision making

Shared Decision Making during the COVID-19 Pandemic

The impact of the emergence of COVID‐19 on women's prenatal genetic testing decisions

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