Shared Decision Making during the COVID-19 Pandemic

Med Decis Making. 2021 May;41(4):430-438. doi: 10.1177/0272989X211004147. Epub 2021 Mar 30.

Abstract

Objective: The COVID-19 pandemic pushed some of the most well-developed health care systems to their limits. In many cases, this has challenged patient-centered care. We set out to examine individuals' attitudes toward shared decision making (SDM) and to identify predictors of participation preference during the pandemic.

Methods: We conducted an online survey with a large convenience sample (N = 1061). Our main measures of interest were participants' generic and COVID-19-related participation preference as well as their acceptance and distress regarding a triage vignette. We also assessed anxiety, e-health literacy, and aspects of participants' health. We conducted group comparisons and multiple linear regression analyses on participation preference as well as triage acceptance.

Results: In generic decision making, most participants expressed a strong need for information and a moderate participation preference. In the hypothetical case of COVID-19 infection, most preferred physician-led decisions. Generic participation preference was the strongest predictor of COVID-19-related participation preference, followed by age, education, and anxiety. Furthermore, both higher generic and COVID-19-related participation preferences predicted lower triage acceptance.

Conclusion: Our findings demonstrate potential health care recipients' attitudes toward SDM during a severe health care crisis and emphasize that participation preference varies according to the context.

Keywords: COVID-19; anxiety; health care; shared decision making; triage.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Anxiety
  • Attitude*
  • COVID-19*
  • Decision Making, Shared*
  • Educational Status
  • Emergencies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pandemics*
  • Patient Participation*
  • SARS-CoV-2
  • Surveys and Questionnaires
  • Triage*