Task-Specific Patient Preferences for Shared Decision-Making in Hand Surgery.

Area of Science:

• Surgical Patient Care
• Shared Decision-Making Models
• Health Psychology

Background:

• Shared decision-making (SDM) in surgery enhances patient engagement, satisfaction, and outcomes.
• Patient preferences for involvement in surgical decisions remain largely uncharacterized.
• Understanding patient desires is crucial for optimizing SDM.

Purpose of the Study:

• To investigate patients' preferred roles in surgical decision-making at different stages.
• To examine the relationship between self-efficacy and patient preferences in SDM.
• To inform tailored approaches to SDM in hand surgery.

Main Methods:

• Survey of patients at an academic hand surgery clinic.
• Utilized validated questionnaires: Control Preference Scale, Problem-Solving Decision-Making Scale, and General Self-Efficacy Scale.
• Employed linear and ordinal logistic regression to analyze self-efficacy's impact on decision-making preferences.

Main Results:

• Patients generally preferred equal decision-making responsibility with surgeons.
• For problem-solving tasks, 81% preferred to defer responsibility; 19% preferred shared decision-making.
• For decision-making tasks, 54% preferred shared decision-making. Higher self-efficacy correlated with preferring more control.

Conclusions:

• Patients desire surgeon expertise for problem-solving but shared responsibility for decision-making.
• Findings support moving beyond paternalistic models in surgical care.
• SDM strategies should be tailored to align with individual patient preferences for optimal care delivery.