Family involvement in medical decision making in Europe and the United States: A replication and extension in five Countries. (May 2022)

• Record Type: Journal Article
• Authors: Scherr, Sebastian; Reifegerste, Doreen; Arendt, Florian; van Weert, Julia C.M.; Alden, Dana L.
• Is Part Of: Social science & medicine. Volume 301(2022)
• Publication Date: 2022-05
• Subjects: Family involvement -- Shared decision making -- Self-involvement -- Self-independence -- Relational interdependence -- Cross-cultural replication -- Europe -- United States (U.S.); Social medicine -- Periodicals; Medical anthropology -- Periodicals; Public health -- Periodicals; Psychology -- Periodicals; Medicine -- Periodicals; Medicine -- Periodicals; Médecine sociale -- Périodiques; Anthropologie médicale -- Périodiques; Santé publique -- Périodiques; Psychologie -- Périodiques; Médecine -- Périodiques; Electronic journals; 362.105
• DOI: 10.1016/j.socscimed.2022.114932
• Languages: English
• ISSNs: 0277-9536

Abstract

Abstract: Background: In 2018, Alden et al. showed that the desired degree of family involvement in medical decisions is an individual preference that is largely independent from East-West cultural stereotypes. At the same time, individual-level interdependence influenced whether patients preferred more individual or more family involvement in their decision making together with their medical care provider. The present study provides empirical evidence and adds evidence for Europe for which no such data previously existed. Methods: The present study is a direct replication and extension of the original Alden et al. (2018) study ( N = 2031; Australia, China, Malaysia, India, South Korea, Thailand, United States [U.S.]), however, using survey data from four European countries (Austria, Belgium, Germany, Netherlands) and the United States (U.S.) with a total sample size of N = 2750. Results: Random effects within-between models replicated the original primary finding that those with higher self-involvement in medical decision making preferred less family involvement. Furthermore, patients with lower self-independence, higher relational interdependence, and stronger beliefs in social hierarchy are more likely to want their families involved in medical decisions besides their health care provider. Conclusions: These observed relationships are largely consistent both within and across the four European countries and the U.S. In conclusion, the results point to the importance of avoiding cultural stereotypes and instead, recognizing that patient desires for family involvement in medical decision making vary dramatically within cultures depending on multiple individual differences. Furthermore, a growing body of evidence suggests that these antecedents of family involvement as well as the construct itself may be measurable in diverse cultures with high levels of confidence in their reliability and validity. Highlights: Family involvement in shared medical decision making can help improving health outcomes. Cultural influences have been identified in Asia-Pacific region but not in Europe. Direct replication of Alden et al. (2017) in four Central European countries and the USA. Higher self-independence and stronger desire for self-involvement decrease family involvement. Higher relational interdependence and stronger beliefs in social hierarchy increase family involvement.