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Gepubliceerd in:

01-10-2011

Interpersonal influences on patients’ surgical decision making: the role of close others

Auteurs: Christine Rini, Lina Jandorf, Rachel E. Goldsmith, Sharon L. Manne, Noam Harpaz, Steven H. Itzkowitz

Gepubliceerd in: Journal of Behavioral Medicine | Uitgave 5/2011

Abstract

Patients make medical decisions in consultation with their partner, family, and friends. However, little is known about the ways in which these close others influence their decisions, particularly with respect to discrete decisions such as those related to medical treatments. This cross-sectional study investigated their influence on the surgical decisions of inflammatory bowel disease patients referred for surgery to remove their colon (N = 91). Guided by research on social control and classic research on power and influence in close relationships, we identified four types of close other decision influence: persuasion, assistance with understanding, indirect influence, and negative influence. Linear logistic and regression analyses showed that patients were more likely to have surgery when their close other used persuasion, and they reported lower decisional conflict when their close other helped them understand the decision. Patients were less likely to have surgery and reported greater decisional conflict when their close other used negative influence tactics. Findings demonstrate the importance of considering social context when investigating patient decision making.

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In differentiating between discrete and ongoing health decisions, we should note that it is not necessarily the case that discrete decisions will never be faced more than once: Some choices are irreversible whereas others may have to be revisited in the future, with additional opportunities for close others’ involvement. For instance, IBD patients who undergo colectomy will never again face the same surgical decision, whereas those who refuse it may need to revisit their decision if they experience another health event that signals a potential need for surgery. Rather, the hallmark of a discrete decision is that it is made at a specific point in time in response to a specific health threat, as when IBD patients are faced with the decision to have or refuse colectomy given their current health status.

The effect of close other sex remained significant even when we controlled for patient sex in this model. Because patient sex was not significantly or marginally significantly associated with decisional conflict, we trimmed it from the model in the interest of parsimony (a procedure also used for other control variables).

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Titel: Interpersonal influences on patients’ surgical decision making: the role of close others
Auteurs: Christine Rini
Lina Jandorf
Rachel E. Goldsmith
Sharon L. Manne
Noam Harpaz
Steven H. Itzkowitz
Publicatiedatum: 01-10-2011
Uitgeverij: Springer US
Gepubliceerd in: Journal of Behavioral Medicine / Uitgave 5/2011
Print ISSN: 0160-7715
Elektronisch ISSN: 1573-3521
DOI: https://doi.org/10.1007/s10865-011-9323-y

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