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Getting specific: participation preference in urooncological decision-making.

Björn Büdenbender1, Anja K Köther1, Maximilian C Kriegmair2

  • 1Department of Psychology, School of Social Sciences, University of Mannheim, L 15-17, 68131, Mannheim, Germany.

BMC Medical Informatics and Decision Making
|July 5, 2023
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Summary
This summary is machine-generated.

Patients’ preferences for participating in medical decisions vary by context. The new Autonomy Preference Index-Urology (API-Uro) tool effectively measures these specific preferences, aiding clinicians in tailoring care to individual patient needs.

Keywords:
Bladder cancerDecision contextOncologyParticipation preferencePatient participationPatient preferenceShared decision-makingUrology

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Area of Science:

  • Urology
  • Oncology
  • Health Psychology

Background:

  • Shared decision-making is crucial in clinical practice.
  • Generic patient preference measures exist (e.g., Autonomy Preference Index, API).
  • Patient preferences can differ based on disease and decision context.

Purpose of the Study:

  • To assess patients' specific participation preferences in urological cancer treatment decisions using a modified index (API-Uro).
  • To compare disease-specific preferences with generic participation preferences.
  • To evaluate the psychometric properties of the API-Uro.

Main Methods:

  • Study 1: 469 urological outpatients completed generic and disease-specific (API-Uro) preference measures. Exploratory factor analysis was used.
  • Study 2: 204 bladder cancer patients validated the API-Uro's factorial structure using confirmatory factor analysis.
  • Analysis of differences in participation preference across decision contexts.

Main Results:

  • API-Uro scores correlated with generic measures but provided incremental information.
  • Two factors emerged from API-Uro: treatment vs. diagnostic decisions.
  • Patients preferred more participation in treatment decisions (77.8%) than diagnostic decisions (22%) in Study 1, and (57.4% vs. 13.3%) in Study 2.

Conclusions:

  • Patient desire for participation differs significantly between treatment and diagnostic decisions in urological care.
  • The API-Uro demonstrates good psychometric properties and is suitable for assessing context-specific preferences.
  • Assessing specific participation preferences can enhance clinical care by addressing individual patient needs.