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Who decides: me or we? family involvement in medical decision making in eastern and western countries


Alden, Dana L. and Friend, John and Ping, Yein Lee and Yew, Kong Lee and Trevena, Lyndal and Chirk, Jenn Ng and Kiatpongsan, Sorapop and Abdullah, Khatijah Lim and Tanaka, Miho and Limpongsanurak, Supanida (2017) Who decides: me or we? family involvement in medical decision making in eastern and western countries. Medical Decision Making, 38 (1). pp. 14-25. ISSN 0272989X


Background: Research suggests that desired family involvement (FI) in medical decision making may depend on cultural values. Unfortunately, the field lacks cross-cultural studies that test this assumption. As a result, providers may be guided by incomplete information or cultural biases rather than patient preferences. Methods: Researchers developed 6 culturally relevant disease scenarios varying from low to high medical seriousness. Quota samples of approximately 290 middle-aged urban residents in Australia, China, Malaysia, India, South Korea, Thailand, and the USA completed an online survey that examined desired levels of FI and identified individual difference predictors in each country. All reliability coefficients were acceptable. Regression models met standard assumptions. Results: The strongest finding across all 7 countries was that those who desired higher self-involvement (SI) in medical decision making also wanted lower FI. On the other hand, respondents who valued relational-interdependence tended to want their families involved – a key finding in 5 of 7 countries. In addition, in 4 of 7 countries, respondents who valued social hierarchy desired higher FI. Other antecedents were less consistent. Conclusion: These results suggest that it is important for health providers to avoid East–West cultural stereotypes. There are meaningful numbers of patients in all 7 countries who want to be individually involved and those individuals tend to prefer lower FI. On the other hand, more interdependent patients are likely to want families involved in many of the countries studied. Thus, individual differences within culture appear to be important in predicting whether a patient desires FI. For this reason, avoiding culture-based assumptions about desired FI during medical decision making is central to providing more effective patient centered care.

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Additional Metadata

Item Type: Article
Divisions: Faculty of Medicine and Health Science
DOI Number: https://doi.org/10.1177/0272989X17715628
Publisher: SAGE Publications
Keywords: Asia; Cross-cultural; Family involvement; Shared decision making
Depositing User: Mohd Hafiz Che Mahasan
Date Deposited: 30 Nov 2018 03:53
Last Modified: 30 Nov 2018 03:53
Altmetrics: http://www.altmetric.com/details.php?domain=psasir.upm.edu.my&doi=10.1177/0272989X17715628
URI: http://psasir.upm.edu.my/id/eprint/63712
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