Evaluation of possibilities of surgical patients to take part in the healthcare decision making process

Aim of the study. To analyze surgical profile patients opportunities to take part in treatment decision making. Objectives. 1. To determine the decision of the patients selecting their health care. 2. To analyze the importance of the written consent approving the surgery. 3. To evaluate patients decision making process improvement possibilities. Methods. Kaunas Clinical University of Medicine surgical profile patients and their opportunities to be involved in health treatment decision making process. Anonymous questionnaire was given to 482 surgical profile patients. The response rate was 80.5% (388 patients). Data analysis was performed with Microsoft Office Excel 2003 and SPSS 14. The standardization process was used, whereas age of the patients used as a standard. Results. Almost half of all respondents (45.0%) have read the information in regards of surgery, before giving their written consent. The majority of the patients (85.8%) said that they knew which surgeon will be doing the surgery. Written consent information was important mostly to respondents who have completed college education and living in the city. The surgeons asked if the information was clear most of the patients who have completed university education (55.1%) and living in the city (65.3%), as well as currently employed (64.9%) compared to the ones who live in suburbs or villages (46.8%), retirees (11.8%) and without a university education degree (8.4%). Almost twice as many respondents who have completed university education (79.6%) compared to the ones who haven‘t completed secondary school education (41.3%) said, that written patient consent is necessary before the surgery. Written and oral consent before surgery requested more patients who were employed (38.3%) compared to retirees (4.1%) and respondents who have received university degree (42.3%) compared to the ones who didn’t have university degree (2.8%). Making a shared decision to have a surgery that doctor and a patient come together was preferred, and women agreed more (80.7%) than men (68.6%), respondents who received university degree (86.3%) agreed more than those who haven‘t finished secondary school (18.3%). The major constrains which did not allow patients to be actively involved in the decision making process, were insufficient medical knowledge (61.5% of women; 48.2% of men); communication difficulties between doctor and a patient (40.4% of women; 26.6% of men); health status (24.3% of men; 22.3% of women). Conclusion. In health care, written consent process is more important to patients who have a university degree, employed and are living in the urban areas. A written and oral consent before surgery was important to patients who had university degree and were employed. The most important difficulties in health care decision making are insufficient medical knowledge, communication difficulties between a patient and a doctor, and patients health status. Women (80.7%) more than men (68.6%) said that a decision between a doctor and a patient to have a surgery has to be shared. Patients who had a university degree (86.3%) and employed patients (68.9%), more than the ones without a university degree (18.3%) and retirees (12.4%) preferred to have a shared decision making between a doctor and a patient