THE IMPORTANCE OF PATIENTS' PERCEIVED INVOLVEMENT IN DECISION MAKING DURING THE PRE-ANAESTHESIA ASSESSMENT

PURPOSE.. Hazardous lifestyle proved to have a significant influence on perioperative development and complications. Thus, a preferable precise preoperative risk assessment is important. We assessed patients' perceived level of involvement in medical decision making and tested the effects of patients' potential risk factors according to their lifestyle. METHODS. We conducted a survey of 286 adults in the pre-anaesthesia clinic before surgery. Patients answered questions on a laptop regarding their consumption of alcohol, nicotine and illicit drugs, social and educational background, weight and exercise. The need for information or the preference to participate in the medical decision process was recorded with the “Perceived Involvement in Care Scale“ (PICS). Descriptive, correlational, and linear regression analyses were conducted.

RESULTS. Most patients were 46 years old (mean = 46.8 years), male (53.1%) and had a BMI > 25 (57.7%). The number of smokers was comparable high with 34.6%. 10% of the population showed a hazardous alcohol intake and 17.6% indicated previous or current drug abuse. 110 preferred a passive role in information seeking, 176 an active role. Most patients believed that their decision-making involvement by obtaining information was relatively active, as indicated by a mean score of 2.82 (ranged from 1-4) on the PICS patient information subscale. Men felt more involved in decision making than women (r = .175; P< .01). Older age was associated with an active role preference (r = 0.256; P<.000) and moderate perceived involvement in decision making (r = 0.183; P<.01). A history of illicit drug abuse was associated with a passive role preference (r = -.147; P<.05). Neither drinking nor smoking habits showed a significant impact on perceived involvement in decision making. Linear regression analyses indicated that age and substance abuse were no longer significantly associated with involvement (β = .165; P = .107 and β = –.095; P = .406), but that sex continued to exhibit an independent effect on perceived involvement in medical decision making (β = .241; P = .021).

CONCLUSIONS. Results suggest that more than hazardous lifestyle sex and age show a significant influence on patients’ perceived involvement in decision making. Thus, doctors in a pre-anaesthesia clinic should offer differential communication skills to meet the need of higher involvement in decision making in female and young patients.