Decisional Conflict During Major Medical Treatment Decision-making: a Survey Study

Area of Science:

• Medical Decision-Making
• Health Literacy Research
• Patient Engagement

Background:

• Decisional conflict is common for patients and surrogates facing life-altering medical choices.
• The link between health literacy and decisional conflict in major medical decisions remains unclear.

Purpose of the Study:

• To determine how many individuals make significant medical treatment decisions for themselves or others.
• To investigate the relationship between decisional conflict and decision-making circumstances, as well as the characteristics of the decision-maker.

Main Methods:

• A two-phase survey study was conducted.
• Phase 1 screened participants for experience with major medical treatment decisions; Phase 2 surveyed eligible individuals about their decision-making process.
• The study utilized the Decisional Conflict Scale and Health Literacy Questionnaire, alongside open-ended questions.

Main Results:

• Approximately 43% of respondents reported making a major medical treatment decision.
• Decisions regarding major surgery and life support were identified as the most challenging.
• Individuals making decisions for a spouse, partner, parent, or other person experienced higher decisional conflict.
• Greater ability to engage with healthcare providers and understand health information correlated with lower decisional conflict.

Conclusions:

• The frequency of major medical treatment decisions is expected to rise, with decisions made on behalf of others being particularly difficult.
• Enhancing communication to foster patient and family involvement in decision-making conversations is crucial, especially for those with limited health literacy.