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Learning Objective 1: 1) Describe the paradigm change from autonomous decision making to shared patient-family decision making in health care.
Learning Objective 2: 2) State which factors are associated with preferences for shared decision making among living kidne donors.
Methods: Degner’s concept of decision control preference was used. Individuals being evaluated in the living kidney donation clinic of a transplant center in a U.S. hospital were surveyed at baseline and by mail three months after donation surgery. At baseline they indicated the decision style used for important health decisions other than donation (independent/shared/reliant). At time 2 (3 mos after surgery) they were asked to indicate the decision style that they had used to make the decision to donate. Results: 254 donors were enrolled and 237 provided complete data to time 2.
Results: 30 (13%) donors preferred a shared decision style to donate. Sex, age, and race were not associated with decision style used to donate but the decision style used for health care decisions other than kidney donation was (chi square 9.53, df = 1, p = .002). Those who normally used the shared style of decision making in health care decisions and married donors, were more likely to use this style in deciding to donate their kidney. Decision style was not related to satisfaction with donation
Conclusion: The preferences for some donor candidates to involve another family member in the decision to be a donor should be respected. Further study should examine whether support for a shared donor decision style would increase the likelihood of donor candidates going on to donation
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