Study of the Elderly Taiwanese Patient’s Medical Autonomy and the Relating Factors
Date Issued
2010
Date
2010
Author(s)
Wang, Shin-Ying
Abstract
Respect for patient autonomy is a primary principle of bioethics and means the right of competent patients to determine their own health issues. With the rapid aging of the Taiwan population, an ever increasing number of elderly confront morbidity and physical decline and limited physical function. Although the demand for relevant information to make informed decisions about treatments is increasing, the preferences and needs of the elderly are often neglected. Understanding the preferences and perceptions of the elderly is the basis for providing appropriate and satisfactory care. The aim of this study, therefore, was to investigate the preferences for autonomy in seeking medical information, participation in medical decision-making and related factors in the elderly population of Taiwan. A cross-sectional study was designed and 98 cases were collected in a medical center in northern Taiwan from August 2009 to October 2009. This study was conducted by purposive sampling and face-to-face interview using the Autonomy Preference Index (API) to measure elderly medical autonomy. Data was analyzed using SPSS software version 15.0.
The results showed that: (1) elderly participation in medical decision-making autonomy preferences of the “elderly - doctor combination” (mean score 2.55 ± 0.52), which means that the elderly tend to collaborate or give the decision to a physician; and the “elderly - family combination” (mean score was 3.64 ± 0.69), which means the elderly prefer to make decisions in collaboration with family or make decision by their own; (2) the elderly have a high intention to seek medical information (mean score 4.40 ± 0.68); (3) the elderly prefer a greater degree of autonomy when faced with making a medical decision about a more serious disease; (4) there is a positive correlation between the preference for information seeking and preference for medical decision-making; (5) among the expectations of the elderly when make a decision, the top two items that elderly expected from a physician were “analysis of the pros and cons” and “ provide detailed information”, and the top two items that the elderly expected family were “accompanying” and “following the recommendation of the physician”; (6) uneducated, high school education, and being aged 76 to 80 years old were predictors of the elderly participation in medical decision – making autonomy preferences for the elderly - doctor combination, the explainable variance is 13.68% (P < .001). Being male, uneducated, aged 76 to 80 years old, not being supported by children, and living alone were predictors of elderly participation in medical decision-making autonomy preferences for the elderly – family combination, the explainable variance is 41% (P < .001). Not being supported by children, uneducated and living alone were predictors of the elderly seeking medical information preferences, the explainable variance is 24.7% (P < .001).
According to these results, providing appropriate and comprehensible medical information may increase the willingness of elder people to participate in the medical decision making. Moreover, in order to improve the communication between medical staff, the elderly and family members, and maintain the decision-making right of elderly, medical staff need to understand the characteristics and willingness of elderly patients and assist them in obtaining medical information or self-expression.
Subjects
elderly
medical autonomy
seeking medical information
participation in medical decision-making
Type
thesis
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