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Who Wants to be involved? Decision-Making Preferences among Residents of Long-Term Care Facilities

Published online by Cambridge University Press:  13 September 2016

Laura M. Funk
Laura M. Funk*
Affiliation:
University of Victoria
*
Laura M. Funk, Centre on Aging, P.O. Box 1700, STN CSC, University of Victoria, Victoria, BC V8W 2Y2, ([email protected])
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Abstract

While the benefits of participating in care or medical decision making are widely reported, research on decision-making participation preferences usually reveals some portion of individuals who do not want to be involved. Data collected through structured, in-person interviews with 100 residents of six long-term care (LTC) facilities in Victoria, British Columbia, were used to examine participation preferences with respect to four types of care decisions (bedtimes, medication choice, room transfer, and advance directives), as well as predictors of these preferences. Residents with higher levels of formal education, a greater number of chronic conditions, and greater confidence about the worth of their input tend to prefer more active involvement in decision making. This research also suggests that predictors of preference for independent control over decision making (active involvement) differ from predictors of preference for joint or shared decision making. Implications for the empowerment of LTC facility residents and the meaning of decision-making involvement in these environments are discussed.

Résumé

Les bienfaits de la participation aux soins ou aux décisions médicales sont largement rapportés, pourtant l'examen des préférences en matière de participation révèle que certaines personnes ne souhaitent pas s'impliquer dans ce processus. Nous nous sommes servis des données recueillies au cours d'entrevues structurées, menées en tête-à-tête avec une centaine de pensionnaires de six établissements de soins de longue durée (SLD) de Victoria, en Colombie-Britannique, pour étudier les préférences en matière de participation liées à quatre types de décisions de soins (heures du coucher, choix de médicaments, transfert dans une autre chambre et directives préalables), et les prédicteurs de ces préférences. En général, les pensionnaires ayant un plus haut niveau d'instruction, un plus grand nombre d'affections chroniques et une plus grande confiance dans leur jugement préfèrent participer plus activement aux décisions. Nos travaux suggèrent également que les prédicteurs de préférence liés au contrôle indépendant de la prise de décisions (la participation ≪ active ≫) diffèrent des prédicteurs de préférence liés à la prise de décisions concertée. Nous explorons les retombées de l'habilitation des pensionnaires d'établissement de SLD et le rôle de la participation à la prise de décisions dans ces cadres de soins.

Keywords

decision makingcontrolempowermentinvolvementagingprise de décisionscontrôlehabilitationparticipationvieillissement
Type
Research Article
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 23 , Issue 1 , Spring 2004 , pp. 47 - 58
Copyright
Copyright © Canadian Association on Gerontology 2004

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Footnotes

*

This research was conducted as part of the M.A. degree program at the University of Victoria and was supported by a studentship award from the British Columbia Health Research Foundation (now the Michael Smith Foundation for Health Research).

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