Barriers and concerns in patient perceptions of shared decision making in China

Article type
Authors
Zhang M, Liu G, Wang H, Chen X, Zhang Q, Wang F, Fan Z, Zhou Y
Abstract
Background: In China, an estimated number of over 90% of patients would like to participate in shared decision making, especially, when increasing financial responsibility for health care falls on their shoulders. With the movement of evidence-based medicine introduced in the country, more and more doctors have recognized the importance of patient involvement. Objectives: To determine the current status of patient attitude in shared clinical decision making and to provide evidence in this field. Methods: We developed a questionnaire with 15 questions concerning patient involvement in decision making which also included the baseline data of patients. In summer of 2007, a group of volunteer medical students distributed the questionnaire to 1000 out-patients, and they gave explanations if patients had any questions while completing the questionnaire. The data were analyzed using MS Excel. Results: A total of 792 questionnaires were collected with some items blank representing 46% male and 49% female patients with the mean age of 45. Over 80% were above high school education, and 62% had medical insurance. How much do patients learn from health information about their diseases: 7% much, 67% some, 24% nothing; how do patients learn the information: 46% from doctors, 36% from public media, 17% from internet; whether patients hope to learn: 95% yes; where patients hope to learn the information from: 60% from doctor, 15% from internet 15% from media); whether patients want their doctors to seek their opinions before making treatment decisions: 91% agree; how many patients are satisfied with their treatment: 27% satisfied, 51% minor satisfied, 16% not satisfied; patients’ concerns and difficulties in the hospital: 50% complain about waiting too long, 37% too little time for communication, 25% high costs; 11% side effects; what patients hope to get from their doctors or hospitals: 37% proven and reliable information, 26% patience with patients, 11% shorten the waiting time. Conclusions: Patient involvement in clinical decision making has been a hot and sensitive topic in China, though it is important, and doctors are encouraged to get their patients involved. The above study shows that both patients and doctors need to understand each other in order to promote a better and more harmonious environment in hospitals in China.