Preferences for Participation in Decision Making Among Ethnically Diverse Patients with Anxiety and Depression
This study explored preferences for treatment decision making using the Control Preferences Scale and Problem Solving Decision Making Scale among a sample of ethnically diverse adults (N = 60) seeking treatment for anxiety and depression. Most participants expressed a desire for participation in shared decision making. Being Hispanic was significantly associated with a more passive role in decision making. Participants preferred more involvement in decision making versus problem solving tasks for both mental and general health vignettes, and more involvement in mental health versus general health decision-making. More research is needed to confirm tentative results on the influence of sociodemographic variables on preferences for role and participation in treatment decision making and the variation in these preferences. Treatment seeking individuals with anxiety and depression have identifiable preferences for participation in decision making. Asking about patient preferences and a better understanding of variability in preferences may improve patient-provider communication.
KeywordsShared decision making Ethnicity Mental health Preferences
This work was supported by a Ruth L. Kirschstein National Research Service Award (NRSA) from the National Institute of Mental Health. Preparation of the manuscript was partially supported by the Center for Evidence-based Practice in the Underserved (P30NR010677).
- Coulter, A. (1997). Partnerships with patients: The pros and cons of shared clinical decision-making. Journal of Health Services Research & Policy, 2, 112–121.Google Scholar
- First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (2002). Structured clinical interview for DSM-IV-TR axis I disorders research version, patient edition (SCID-I/P). New York: Biometrics Research, New York State Psychiatric Institute.Google Scholar
- Grant, B. F., Stinson, F. S., Hasin, D. S., Dawson, D. A., Chou, S. P., & Anderson, K. (2004). Immigration and lifetime prevalence of DSM-IV psychiatric disorders among Mexican Americans and non-hispanic whites in the United States: Results from the national epidemiologic survey on alcohol and related conditions. Archives of General Psychiatry, 61, 1226–1233.CrossRefPubMedGoogle Scholar
- Institute of Medicine. (2005). Improving the quality of health care for mental and substance use conditions: Quality chasm series. Washington, DC: National Academies Press.Google Scholar
- Kraetschmer, N. (1994). Preferences of patients undergoing angiogram for participation in treatment decisions: Coping style and problem solving decision-making scale. Thesis, Graduate Department of Community Health, University of Toronto, Toronto, Ontario.Google Scholar
- Ngo-Metzger, Q., Telfair, J., Sorkin, D. H., et al. (2006). Cultural competency and quality of care: Obtaining the patient’s perspective. The Commonwealth Fund.Google Scholar
- NIH Policy on reporting race and ethnicity data: Subjects in clinical research. Retrieved Feb 11, 2010 from http://grants.nih.gov/grants/guide/notice-files/NOT-OD-01-053.html.
- Ottowa Health Research Institute. (2008). Patient decision aids. Retrieved December 19, 2008 from http://decisionaid.ohri.ca/index.html.
- Ramirez, R. R., & de la Cruz, G. P. (2002). The hispanic population in the United States: March 2002. Current Population Reports, P20–545, US Census Bureau, Washington, DC.Google Scholar
- Roter, D. L., & Hall, J. A. (1993). Doctors talking with patients/patients talking with doctors: Improving communication in medical visits (pp. 21–38). Westport, CT: Auburn House.Google Scholar
- Ryan, M., & Gerard, K. (2003). Using choice experiment to value health care programmes: Current practice and future prospects. Applied Health Economics Policy Annals, 2, 55–64.Google Scholar
- Smedley, B. D., Stith, A. Y., & Nelson, A. R. (2002). Unequal treatment: Confronting racial and ethnic disparities in health care. Washington, DC: National Academy Press.Google Scholar
- U.S. Bureau of the Census, Population Division, Special Population Staff. (2007). Racial and ethnic classifications used in the census in 2000 and beyond. Retrieved Feb 21, 2007 from www.census.gov/population/www/socdemo/race/racefactcb.html.