The importance of the study, says lead investigator Donna E. Stewart, M.D., of University Health Network and University of Toronto, is that patients tend to recover better when they have more information and are more involved in their own treatment decisions. The article appears in the current issue of Psychosomatic Medicine.
Stewart suggests wider dissemination among health professionals, especially doctors, of data regarding "the beneficial effects of patient involvement in decision-making on health outcomes."
"Because providing more information and meeting preferences for decisional roles may result in better self-efficacy, patient satisfaction and preventive health behavior in the year after (an acute heart disease), clinicians must do better," Stewart says.
Despite a clear preference for sharing decision-making with the doctor, more than half the patients reported that the doctor made the main decision and 35 percent said the doctor did not seriously consider their opinion.
In the study, more than 500 patients who had been hospitalized in 12 coronary intensive care units in Ontario for either heart attack or unstable angina were asked six months and again one year after treatment for their impression of how much they participated in medical decision-making and how much information they wanted and received from doctors, nurses and other health care providers.
Both men and women scored 4.34 on a five-point scale indicating their desire for information about managing their condition. But when asked their perception of the amount of information they did receive, after six months the average score was 3.63, with men significantly more positive in their assessment than women.
After one year, men were 30 percent more likely to report satisfaction in getting test results from their family doctor and 23 percent more likely to get information about cardiac rehabilitation.
"Our findings show that patients … at six and 12 months feel only moderately well informed about their disease and that they would like more information about many topics," Stewart says. "Information provision regarding diet, high cholesterol and exercise may result in behavior changes that could significantly reduce their chance of suffering a recurrence."
Women wanted more information than men, in general, and specifically more information about angina and high blood pressure. Men wanted more information about sexual function.
Among both genders, however, "the amount of information the patients perceived that they had obtained from their health care providers about the management of their heart condition revealed a significant gap between what they wanted and what they perceived they received, with women wanting more information than men."
The study was supported by a grant from the Heart and Stroke Foundation of Canada.
BY IRA R. ALLEN
HEALTH BEHAVIOR NEWS SERVICE
FOR MORE INFORMATION:
Health Behavior News Service: 202-387-2829 or http://www.hbns.org.
Interviews: Contact Dr. Donna Stewart at 416-340-3846 or Donna.Stewart@uhn.on.ca.
Psychosomatic Medicine: Contact Victoria White at 352-376-1611, ext. 5300, or psychosomatic@medicine.ufl.edu. Online, visit http://www.psychosomaticmedicine.org.
Journal
Psychosomatic Medicine