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Patient/Physician Communication

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Personality is linked to active and passive decisionmaking style

Patient involvement in medical decisions affecting their care is highly recommended. However, doctors should respect each patient's preference for the level of involvement in health care decisions, suggest Kathryn E. Flynn, Ph.D., of Duke University, and Maureen A. Smith, M.D., M.P.H., Ph.D., of the University of Wisconsin.

Their new study found that a patient's decisionmaking style appears to be linked to personality. Persons who are conscientious (usually self-disciplined and ambitious), less neurotic (less anxious and self-conscious), and open to experience, but also less agreeable, tend to be the most active decisionmakers. They prefer to make important medical decisions about their care and to participate in the discussion of treatment choices (deliberation process).

More agreeable individuals may be less confrontational with doctors and may not be bothered when doctors assume the traditional paternalistic role, explain the researchers. They surveyed 5,830 adults (63 to 66 years) to explore the relationship between 5 personality factors (extraversion, agreeableness, conscientiousness, neuroticism, and openness to experience) and preferences for the health care decisionmaking process: information exchange, deliberation, and selection of treatment. They examined the relationship between decisionmaking style and personal, health, social, and economic factors. Decisionmaking style appeared to reflect primarily personal factors.

Four of the five personality factors (all but extroversion) helped explain differences between the most and least active decisionmakers. Higher education was also associated with preferences for more active participation in decisionmaking.

The study was supported in part by the Agency for Healthcare Research and Quality (HS15544).

More details are in "Personality and health care decision-making style," by Drs. Flynn and Smith, in the Journal of Gerontology: Psychological Sciences 62B (5), pp. 261-267, 2007.

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