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Research

Shared decision-making experienced by Canadians facing health care decisions: a Web-based survey

Julie Haesebaert, Rhéda Adekpedjou, Jordie Croteau, Hubert Robitaille and France Légaré
April 04, 2019 7 (2) E210-E216; DOI: https://doi.org/10.9778/cmajo.20180202
Julie Haesebaert
Centre de recherche sur les soins et services de première ligne de l’Université Laval, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, and Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec, Que.
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Rhéda Adekpedjou
Centre de recherche sur les soins et services de première ligne de l’Université Laval, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, and Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec, Que.
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Jordie Croteau
Centre de recherche sur les soins et services de première ligne de l’Université Laval, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, and Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec, Que.
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Hubert Robitaille
Centre de recherche sur les soins et services de première ligne de l’Université Laval, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, and Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec, Que.
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France Légaré
Centre de recherche sur les soins et services de première ligne de l’Université Laval, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, and Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec, Que.
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  • Figure 1:
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    Figure 1:

    Flow chart showing selection of participants.

Tables

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    Table 1:

    Respondents’ descriptive sociodemographic characteristics (total weighted n = 1010)

    CharacteristicNo. (%) of respondents
    UnweightedWeighted*
    Age, yr
     18–2434 (3.4)55 (5.4)
     25–34131 (13.0)204 (20.2)
     35–44136 (13.5)134 (13.3)
     45–54204 (20.2)200 (19.8)
     55–64231 (22.9)179 (17.7)
     ≥ 65274 (27.1)238 (23.6)
    Sex
     Male492 (48.7)467 (46.2)
     Female518 (51.3)543 (53.8)
    Marital status
     Single184 (18.2)214 (21.2)
     Married/common-law662 (65.5)649 (64.2)
     Separated/divorced101 (10.0)89 (8.8)
     Widowed48 (4.8)42 (4.2)
     Prefer not to answer15 (1.5)16 (1.6)
    Member of household receiving home care
     Yes79 (7.8)90 (8.9)
     No922 (91.3)908 (89.9)
     Prefer not to answer9 (0.9)12 (1.2)
    Geographical area
     Urban455 (45.0)476 (47.1)
     Suburban356 (35.2)353 (35.0)
     Rural190 (18.8)173 (17.1)
     Do not know/prefer not to answer9 (0.9)9 (0.9)
    Ethnicity
     White861 (85.2)793 (78.5)
     Nonwhite139 (13.8)199 (19.7)
     Declined to answer10 (1.0)18 (1.8)
    Level of education
     Elementary9 (0.9)20 (2.0)
     High school191 (18.9)277 (27.4)
     College335 (33.2)310 (30.7)
     University certificate/diploma85 (8.4)68 (6.7)
     University387 (38.3)328 (32.5)
     Prefer not to answer3 (0.3)8 (0.8)
    Occupation, weighted
     Worker497 (49.2)516 (51.1)
     Unemployed467 (46.2)429 (42.5)
     Full-time studies30 (3.0)45 (4.4)
     Prefer not to answer16 (1.6)19 (1.9)
    Total family income, $
     ≤ 19 99965 (6.4)85 (8.4)
     20 000–39 999129 (12.8)132 (13.1)
     40 000–59 999156 (15.4)169 (16.7)
     60 000–79 999147 (14.6)141 (14.0)
     80 000–99 999132 (13.1)131 (13.0)
     100 000–124 999114 (11.3)97 (9.6)
     125 000–149 99960 (5.9)54 (5.3)
     ≥ 150 00083 (8.2)83 (8.2)
     Prefer not to answer124 (12.3)118 (11.7)
    Province
     British Columbia92 (9.1)142 (14.0)
     Alberta69 (6.8)104 (10.3)
     Manitoba/Saskatchewan68 (6.7)58 (5.7)
     Ontario335 (33.2)335 (33.2)
     Quebec383 (37.9)307 (30.4)
     Atlantic provinces63 (6.2)65 (6.4)
    First language
     French375 (37.1)274 (27.1)
     English524 (51.9)511 (50.6)
     Other109 (10.8)221 (21.9)
     Prefer not to answer2 (0.2)5 (0.5)
    • ↵* Weighted to Canadian census targets for age, sex, region and language based on distributions reported in the 2016 Canadian census. Numbers may not total 1010 in all cases as the weighting process involves approximations; the sum of approximations may lead to a difference of +1 or −1 in the total.

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    Table 2:

    Descriptive statistics of shared decision-making outcomes (total weighted n = 1010)

    Outcome; responseNo. (%) of respondents
    UnweightedWeighted*
    Choice discussed
     Always196 (19.4)193 (19.1)
     Often235 (23.3)239 (23.7)
     Sometimes301 (29.8)293 (29.0)
     Rarely106 (10.5)104 (10.3)
     Never130 (12.9)134 (13.3)
     Do not know/prefer not to answer42 (4.2)46 (4.6)
    Advantages/disadvantages presented
     Always198 (19.6)206 (20.4)
     Often236 (23.4)253 (25.0)
     Sometimes262 (25.9)243 (24.1)
     Rarely140 (13.9)130 (12.9)
     Never140 (13.9)142 (14.1)
     Do not know/prefer not to answer34 (3.4)35 (3.5)
    Asked about ideas/preferences
     Always168 (16.6)169 (16.7)
     Often219 (21.7)223 (22.1)
     Sometimes245 (24.2)245 (24.3)
     Rarely182 (18.0)177 (17.5)
     Never157 (15.5)154 (15.2)
     Do not know/prefer not to answer39 (3.9)43 (4.3)
    Asked about preferred option
     Always170 (16.8)173 (17.1)
     Often224 (22.2)233 (23.1)
     Sometimes250 (24.8)250 (24.8)
     Rarely161 (15.9)147 (14.6)
     Never164 (16.2)163 (16.1)
     Do not know/prefer not to answer41 (4.1)43 (4.3)
    Match between preferred and actual level of participation
     Always244 (24.2)256 (25.3)
     Often279 (27.6)291 (28.8)
     Sometimes219 (21.7)211 (20.9)
     Rarely142 (14.1)132 (13.1)
     Never90 (8.9)89 (8.8)
     Do not know/prefer not to answer36 (3.6)32 (3.2)
    • ↵* Weighted to Canadian census targets for age, sex, region and language based on distributions reported in the 2016 Canadian census. Numbers may not total 1010 in all cases as the weighting process involves approximations; the sum of approximations may lead to a difference of +1 or −1 in the total.

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    Table 3:

    Weighted multiple regression for average score and 5 outcomes

    VariableItem; β (95% CI)
    Average score*Choice discussedAdvantages/disadvantages presentedAsked about ideas/preferencesAsked about preferred optionMatch between preferred and actual level of participation
    Age, yr
     18–24ReferenceReferenceReferenceReferenceReferenceReference
     25–34−0.47 (−0.83 to −0.1)−0.41 (−0.86 to 0.04)−0.61 (−1.05 to −0.17)−0.42 (−0.92 to 0.07)−0.43 (−0.97 to 0.12)−0.46 (−0.9 to −0.01)
     35–44−0.69 (−1.1 to −0.29)−0.56 (−1.04 to −0.09)−0.86 (−1.32 to −0.40)−0.60 (−1.12 to −0.08)−0.69 (−1.25 to −0.12)−0.76 (−1.23 to −0.30)
     45–54−0.63 (−0.99 to −0.27)−0.54 (−0.97 to −0.11)−0.88 (−1.3 to −0.45)−0.39 (−0.88 to 0.10)−0.64 (−1.19 to −0.10)−0.69 (−1.11 to −0.27)
     55–64−0.67 (−1.02 to −0.32)−0.55 (−0.97 to −0.13)−0.87 (−1.29 to −0.46)−0.50 (−0.99 to −0.02)−0.66 (−1.2 to −0.13)−0.75 (−1.17 to −0.33)
     ≥ 65−0.90 (−1.26 to −0.54)−0.80 (−1.23 to −0.37)−1.14 (−1.57 to −0.72)−0.84 (−1.33 to −0.34)−0.90 (−1.44 to −0.35)−0.81 (−1.23 to −0.38)
    Member of household receiving home care
     NoReferenceReferenceReferenceReferenceReferenceReference
     Yes0.45 (0.15 to 0.75)0.44 (0.1 to 0.78)0.49 (0.13 to 0.85)0.50 (0.16 to 0.84)0.45 (0.11 to 0.78)0.37 (0.03 to 0.70)
    Geographical area
     UrbanReferenceReferenceReferenceReferenceReferenceReference
     Suburban−0.14 (−0.33 to 0.05)−0.16 (−0.38 to 0.05)−0.12 (−0.34 to 0.10)−0.13 (−0.34 to 0.08)−0.14 (−0.36 to 0.08)−0.13 (−0.34 to 0.07)
     Rural−0.37 (−0.61 to −0.13)−0.48 (−0.76 to −0.20)−0.36 (−0.63 to −0.10)−0.41 (−0.67 to −0.15)−0.35 (−0.61 to −0.08)−0.26 (−0.54 to 0.02)
    Province
     Atlantic provincesReferenceReferenceReferenceReferenceReferenceReference
     British Columbia−0.07 (−0.47 to 0.33)−0.04 (−0.50 to 0.41)0.07 (−0.38 to 0.53)−0.17 (−0.65 to 0.30)0.03 (−0.43 to 0.49)−0.23 (−0.67 to 0.21)
     Alberta−0.19 (−0.61 to 0.24)−0.10 (−0.60 to 0.40)−0.16 (−0.67 to 0.34)−0.36 (−0.84 to 0.12)−0.01 (−0.48 to 0.47−0.32 (−0.79 to 0.15)
     Manitoba/Saskatchewan−0.08 (−0.48 to 0.32)0.04 (−0.42 to 0.50)0.00 (−0.47 to 0.48)−0.19 (−0.71 to 0.32−0.09 (−0.57 to 0.39)−0.15 (−0.57 to 0.28)
     Ontario−0.20 (−0.50 to 0.11)−0.08 (−0.44 to 0.27)−0.06 (−0.43 to 0.31)−0.34 (−0.72 to 0.05)−0.19 (−0.56 to 0.18)−0.31 (−0.65 to 0.03)
     Quebec−0.29 (−0.60 to 0.02)0.07 (−0.28 to 0.42)−0.19 (−0.55 to 0.18)−0.38 (−0.77 to 0.01)−0.40 (−0.78 to −0.01)−0.55 (−0.9 to −0.21)
    Ethnicity
     NonwhiteReferenceReferenceReferenceReferenceReferenceReference
     White0.21 (−0.03 to 0.45)0.12 (−0.15 to 0.40)0.24 (−0.03 to 0.51)0.13 (−0.14 to 0.41)0.19 (−0.08 to 0.46)0.37 (0.09 to 0.64)
    • Note: CI = confidence interval.

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Shared decision-making experienced by Canadians facing health care decisions: a Web-based survey
Julie Haesebaert, Rhéda Adekpedjou, Jordie Croteau, Hubert Robitaille, France Légaré
Apr 2019, 7 (2) E210-E216; DOI: 10.9778/cmajo.20180202

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Shared decision-making experienced by Canadians facing health care decisions: a Web-based survey
Julie Haesebaert, Rhéda Adekpedjou, Jordie Croteau, Hubert Robitaille, France Légaré
Apr 2019, 7 (2) E210-E216; DOI: 10.9778/cmajo.20180202
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