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Prioritization and heterogeneity in information disclosure: a conjoint and cluster analysis on Chinese medical
1Department of Medical Humanities, School of Humanities, Southeast University, Room 1419, The New Humanities Building, Jiulonghu Campu, Nanjing, China. ccq0213@outlook.com.
Aim:
The study aims to explore (1) Chinese medical students' prioritization of various factors in decision-making about disclosing information to patients with life-threatening illness, (2) heterogeneous subgroups with respective prioritization of factors and, (3) between-subgroup differences in basic demographics and background information.
Methods:
In a cross-sectional observational survey, 196 second-year master's medical students in mainland China reported preferences for disclosing diagnoses and prognoses to terminal cancer patients in 18 scenarios varying in patient preference, family preference, patient sex, age, education, and finance. Conjoint analysis was performed on the entire sample for diagnosis and prognosis disclosure preferences. Cluster analysis identified homogeneous subgroups, followed by conjoint analysis within each cluster. ANOVAs and chi-squared tests compared basic demographics and background information between clusters.
Results:
Conjoint analysis found similar factor prioritization for both diagnosis and prognosis disclosure. The most important are patient preference (27.57%) and family preference (24.88%), followed by patient age (15.38%), finance (13.14%), education (11.10%), and sex (7.74%). With diagnosis and prognosis disclosure preference scores combined, cluster analysis identified three subgroups: A preference-driven group (n = 109) that mainly considers patient preference and family preference; a condition-driven group (n = 29) that prioritizes patient age and finance; and a balanced consideration group (n = 58) that takes relatively even consideration of all factors. Between-cluster comparisons unveiled significant differences in sex and major.
Conclusion:
Incorporating both Western and Confucian values, as well as practical factors, these medical students act as active agents in the decision-making process, guided by their personal identities and professional beliefs.
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