Patient silence hinders shared decision making

Doctor patient

Even though patients want a say in treatment decisions, most don't want to disagree with their doctor, according to a study published online Monday in the Archives of Internal Medicine.

More than 90 percent of patients could visualize asking questions and discussing preferences, and almost 80 percent felt they had the ability to disagree. However, the study found that only 14 percent of patients would actually challenge their doctor if their preferences conflicted with treatment recommendations.

Among those not willing to disagree, about 47 percent feared being labeled "difficult," while 40 percent worried such actions would lead to a damaged relationship, and more than 51 percent thought it might compromise care, according to the study.

Patient fears to disagree with physicians prevent the progression of patient-centered care and shared decision-making, the authors noted, adding that poor communication between both parties can cause inferior outcomes, Reuters reported.

Reinforcing the need for more patient-centered care and patient engagement, a new study published in the July 2012 issue of the journal Perspectives on Psychological Science concluded that patient autonomy is key to improving health. Researchers found that patient feelings of autonomy, competence and relatedness were associated to better mental and physical health.

"Our results showed that supporting patients' psychological needs is essential to practitioners in helping patients attain their health goals and outcomes," psychological scientist Johan Ng of the University of Birmingham said yesterday in a statement.

To learn more:
- here's the Archives of Internal Medicine study abstract
- here's the Perspectives on Psychological Science statement and study abstract

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