Learning Objective 1: The learner will be able to identify the kinds of decision-making preference in health care.
Learning Objective 2: The learner will be able to consider cultural aspect related to decision-making preference in health care.
The purpose of this study is to clarify the differences of perception of the preferences of competent adults for involving family in health care decision-making; the consistency of Decision Control Preference (DCP) of the adult and their family members; and the relevance between the consistency and the family functioning.
A structured questionnaire was administered to 21 pairs of a healthy adult and a family member whom they preferred to involve in important health care decisions in Japan. The Decision-Making Scales (Ito, et al, 2010) has 9 items ranging from “Patient makes final decision” to “Physician makes final decision,” which was adapted from the DCP Scale (Degner, 1992; 1997) and modified version of this scale (Nolan, et al., 2005). Family functioning was measured using the Family Assessment Device (FAD), which was originally developed by Epstein, et. al. (Epstein, 1983) and translated into Japanese (Saeki, 1997).
10 males and 11 females and their family members answered questionnaires. The most common decision-making preference desired by two-thirds of the participants was that “The patient finally makes his/her own decision after consulting with the physician and family.” Two-thirds of the adults and their families thought family could make decisions in health care to some extent on behalf of a competent patient. Only four pairs of the adults and their family members matched on the DCPS, and there were no significant differences between the DCPS matched and the FAD and its subscales.
The decision-making preferences toward a competent patient among the adults and their family members were varied, but family could play a crucial role in health care decision-making. Nurses are in the ideal role to facilitate discussions of preferences between patients and their family members.