A qualitative exploration of treatment decision-making role preference in adult asthma patients

Health Expect. 2002 Sep;5(3):223-35. doi: 10.1046/j.1369-6513.2002.00181.x.


Objectives: To explore preferred treatment decision-making roles, and rationales for role preference, and to identify perceived facilitators to and barriers from attaining preferred role.

Design: Qualitative design.

Setting and participants: One secondary care and four primary care sites in North-west England. Purposive sample of 32 adult asthma patients with varied socio-economic backgrounds and disease severity.

Methods: Tape-recorded focused-conversation style interviews. Interview topic guide derived from the literature. Sort cards employed to provide the focus for exploration of role preferences.

Results: Active (n = 7), collaborative (n = 11) and passive (n = 14) decisional role preferences were identified. Respondents cited level of knowledge; trust; duration of condition; severity of condition at the decisional juncture; lifelong nature of asthma; a perception that 'it is my body'; characteristics of the individual and their response to health professionals as influencing role preference. Perceived facilitators and barriers to participation included condition-related knowledge, practical issues (e.g. lack of time during consultation) and clinicians' interpersonal skills.

Conclusions: Most respondents wished to contribute to or feel involved in treatment decision-making, but not necessarily to control it. Some hindrances to participation would be amenable to intervention. The quality of the provider-patient relationship is central to facilitating participation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Asthma / classification
  • Asthma / therapy*
  • Attitude to Health
  • Decision Making*
  • England
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Participation*
  • Physician-Patient Relations*
  • Severity of Illness Index
  • Social Class