[Perceived support for autonomy in general practice: a multicenter cross-sectional study]

Respecting patient autonomy is one of the guiding principles of contemporary medical ethics. Supporting autonomy can improve patients' health literacy and promote their adherence to and the outcomes of medical treatments. Quantitative studies on the extent of patients' experience of autonomy and the predictors of this experience are lacking in general practice.

In a multicenter cross-sectional study, patients in three general practices in Lower Saxony were surveyed in 2024. Via a paper-pencil questionnaire, patient characteristics and perceived autonomy were assessed using the German version of the Health Care Climate Questionnaire (HCCQ).

The study included n=637 participants. Participants demonstrated a high level of perceived autonomy on a scale of 1-7 (M=6.1, SD=1.1). In the multi-regression analysis, age (ß=0.127; T=2.609; p=0.009), partnership (ß=0.101; T=2.421; p=0.016), and education level (ß=-0.112; T=-2.518; p=0.012) emerged as statistically significant predictors.

This study was the first to quantitatively assess patients' experience of autonomy in a general practice setting in Germany. Overall, a higher level of autonomy was observed than in studies in inpatient settings. This might indicate an egalitarian doctor-patient relationship and a situation in which patients already feel that their individual autonomy is recognized. The analysis of predictors provides evidence that specific groups, such as those with low levels of education, should be specifically helped in the promotion of autonomy.