• Dana L Alden, Miwa Y Merz, and Jun Akashi.
• University of Hawai'i, Honolulu, Hawai'i 96822, USA. dalden@hawaii.edu
• Asia Pac J Public Health. 2012 Jan 1;24(1):173-84.

AbstractStudies in Japan and the United States investigate preferences for patient-physician decision-making style among young adults in the context of a primary care clinic visit for an upper respiratory infection. A treatment scenario described 1 of 3 decision-making styles: a young adult and doctor using a passive (physician decides), shared (patient and physician decide together), or autonomous (patient decides from a set of medically appropriate alternatives) decision-making style. Unexpectedly, Japanese respondents evaluated the autonomous interaction most positively. US respondents evaluated the shared decision-making scenario most positively. Overall, despite large cultural differences, both country samples favored higher participation in decision making. These results suggest that passive patient approaches are falling out of favor as patient-centered care expectations diffuse globally, even in traditionally hierarchic societies with high levels of respect for authority. The implications of these findings along with managerial implications and suggestions for future research are presented.

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