Decision-making preferences towards surgical intervention in a Hong Kong Chinese population

Background: Economic, social, ethical and legal concerns are motivating changes in western-type health practice to encourage individuals to participate in health-care decisions. Patient participation in health care is perceived to be beneficial because health care is negotiated with the patient so the selected regimen of care is more likely to be acceptable. Hong Kong, in accordance with contemporary trends in other industrialized countries, has adopted a Patient's Charter that outlines patient's rights regarding health treatment and choices. Studies indicate that not all patients wish to take part in decision making about treatment. Aim: To explore the degree to which a Hong Kong Chinese population desired to participate in decision making about surgical intervention. Method: 96 participants, 49 surgical and medical patients and 47 students of nursing, participated. Participants were given three hypothetical scenarios: cardiac failure, where major surgery is suggested; cholecystitis, where routine surgery is suggested; and the presence of a benign skin lesion, where minor surgery is suggested. Participants were asked about the degree to which they desired to participate in the decision-making process. There were five choices, ranging from the doctor having full control, to various types of collaborative decision making, to the individual having full control. Results: When the medical condition is not severe, participants desired greater participation in the decision-making process. Younger participants desired greater collaboration with the doctor in decision making while older participants preferred the doctor to have the greater input with respect to decision making.