• Christoph Becker, Sebastian Gross, Martina Gamp, Katharina Beck, Simon A Amacher, Jonas Mueller, Chantal Bohren, René Blatter, Rainer Schaefert, Philipp Schuetz, Joerg Leuppi, Stefano Bassetti, and Sabina Hunziker.
• Medical Communication, Department of Psychosomatic Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, CH, Switzerland.
• J Gen Intern Med. 2023 Apr 1; 38 (5): 118011891180-1189.

BackgroundPatients may prefer different levels of involvement in decision-making regarding their medical care which may influence their medical knowledge.ObjectiveWe investigated associations of patients' decisional control preference (DCP) with their medical knowledge, ward round performance measures (e.g., duration, occurrence of sensitive topics), and perceived quality of care measures (e.g., trust in the healthcare team, satisfaction with hospital stay).DesignThis is a secondary analysis of a randomized controlled multicenter trial conducted between 2017 and 2019 at 3 Swiss teaching hospitals.ParticipantsAdult patients that were hospitalized for inpatient care.Main MeasuresThe primary outcome was patients' subjective average knowledge of their medical care (rated on a visual analog scale from 0 to 100). We classified patients as active, collaborative, and passive according to the Control Preference Scale. Data collection was performed before, during, and after the ward round.Key ResultsAmong the 761 included patients, those with a passive DCP had a similar subjective average (mean ± SD) knowledge (81.3 ± 19.4 points) compared to patients with a collaborative DCP (78.7 ± 20.3 points) and active DCP (81.3 ± 21.5 points), p = 0.25. Regarding patients' trust in physicians and nurses, we found that patients with an active vs. passive DCP reported significantly less trust in physicians (adjusted difference, - 5.08 [95% CI, - 8.69 to - 1.48 points], p = 0.006) and in nurses (adjusted difference, - 3.41 [95% CI, - 6.51 to - 0.31 points], p = 0.031). Also, patients with an active vs. passive DCP were significantly less satisfied with their hospital stay (adjusted difference, - 7.17 [95% CI, - 11.01 to - 3.34 points], p < 0.001).ConclusionPatients with active DCP have lower trust in the healthcare team and lower overall satisfaction despite similar perceived medical knowledge. The knowledge of a patient's DCP may help to individualize patient-centered care. A personalized approach may improve the patient-physician relationship and increase patients' satisfaction with medical care.Trial RegistrationClinicalTrials.gov (NCT03210987).© 2022. The Author(s).

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