Bibliographic Details
| Title: |
Power asymmetry and embarrassment in shared decision-making: predicting participation preference and decisional conflict |
| Authors: |
Karin Antonia Scherer, Björn Büdenbender, Anja K. Blum, Britta Grüne, Maximilian C. Kriegmair, Maurice S. Michel, Georg W. Alpers |
| Source: |
BMC Medical Informatics and Decision Making, Vol 25, Iss 1, Pp 1-15 (2025) |
| Publisher Information: |
BMC, 2025. |
| Publication Year: |
2025 |
| Collection: |
LCC:Computer applications to medicine. Medical informatics |
| Subject Terms: |
Shared decision-making, Patient-clinician interaction, Patient participation, Participation preference, Embarrassment, Power asymmetry, Computer applications to medicine. Medical informatics, R858-859.7 |
| More Details: |
Abstract Background Shared decision-making (SDM) is the gold standard for patient-clinician interaction, yet many patients are not actively involved in medical consultations and hesitate to engage in decisions on their health. Despite considerable efforts to improve implementation, research on barriers to SDM within the patient-clinician relationship and interaction is scant. To identify potential barriers to urological patients’ participation in decision-making, we developed two novel scales assessing power asymmetry (PA-ME) and embarrassment in medical encounters (EmMed). The present study validates both scales in a large sample comprising urological patients and non-clinical participants. It further examines the effects of both factors on participation preferences and decisional conflict among patients. Methods Data were collected from 107 urological patients at a university hospital for Urology and Urosurgery in Germany. Patients completed self-report questionnaires before and after their clinical appointments. In addition, 250 non-clinical participants provided data via an online study. All participants rated perceived power asymmetry in the patient-clinician relationship and their experience of embarrassment in medical contexts using the PA-ME and EmMed scales. Urological patients further indicated their participation preference in decisions regarding both general and urological care prior to the consultation. Afterward, they assessed the level of perceived decisional conflict. Results Factor analyses yielded power asymmetry and medical embarrassment as unidimensional constructs. Both questionnaires have good (PA-ME; α = 0.88), respectively excellent (EmMed; α = 0.95), internal consistency. Among urological patients, higher levels of perceived power asymmetry predicted lower generic participation preference (β = − 0.98, p |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
1472-6947 |
| Relation: |
https://doaj.org/toc/1472-6947 |
| DOI: |
10.1186/s12911-025-02938-4 |
| Access URL: |
https://doaj.org/article/ad753cb595694375b53ae666def19851 |
| Accession Number: |
edsdoj.753cb595694375b53ae666def19851 |
| Database: |
Directory of Open Access Journals |
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