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Patient autonomy in multiple sclerosis--possible goals and assessment strategies
1Institute of Neuroimmunology and Clinical MS Research, University Medical Center Hamburg, Hamburg, Germany. heesen@uke.uni-hamburg.de
Journal of the Neurological Sciences
|May 29, 2013
Summary
This review explores patient autonomy in medical decisions for multiple sclerosis (MS) patients. It details measurement tools for understanding patient preferences and shared decision-making processes to improve health outcomes.
Area of Science:
- Medical Decision Making
- Health Psychology
- Neuroimmunology
Background:
- Patient autonomy is crucial for effective medical decision-making, particularly in chronic conditions.
- Multiple Sclerosis (MS) presents unique challenges due to patient expertise and treatment uncertainties.
- Shared decision-making (SDM) is a key framework for incorporating patient autonomy.
Purpose of the Study:
- To review measurement issues in studying patient autonomy in MS decision-making.
- To categorize these issues by prerequisites, processes, and outcomes.
- To provide an overview of factors influencing medical decision-making in MS.
Main Methods:
- Categorization of measurement issues related to patient autonomy in MS.
- Discussion of prerequisites: role preferences, risk knowledge, tolerance, and attribution.
- Review of intra-psychic (e.g., Theory of Planned Behavior) and interpersonal (e.g., MAPPIN'SDM) process measures.
Main Results:
- Identified key prerequisites, intra-psychic, and interpersonal processes influencing MS patient decisions.
- Introduced measurement concepts for uncertainty management and SDM (MAPPIN'SDM).
- Evaluated outcomes like preference match, decisional conflict, and informed choice in MS.
Conclusions:
- Understanding patient-inherent and interpersonal factors is vital for optimizing medical decision-making in MS.
- Developed and reviewed various measurement tools to assess patient autonomy in chronic disease contexts.
- These insights can enhance health behavior and outcomes for MS patients and beyond.
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