Getting Involved in Decisions

Anchoring Vignettes for Getting Involved in Decisions

Questions:

Now, how would you rate [your/name's] experience of getting involved as much as [you/he/she] wanted to be in making decisions about [your/his/her] care or treatment?

Response categories:

  1. Very good
  2. Good
  3. Moderate
  4. Very bad
  5. Bad

Vignettes:

  1. [Henry] has recently been diagnosed with diabetes. The first time he went to the clinic he had blood tests, eye tests and other routine tests, which he was reluctant to take. After the nurse explained what was involved in the procedures, [Henry] agreed to have the tests. After one test, the result they got was not clear so the nurse asked [Henry] if they could run the test again.

  2. [John] has been diagnosed as having a deadly disease. The doctor has spent time discussing the different drug therapies, the counselling support available, and other medical care that may be needed. The doctor has advised John to start taking medication. [John] said he would like to take some time to decide whether he wanted to start his medication as it would affect the quality of his life. The doctor said that was a good idea and they could discuss it again in a week.

  3. [Steve] is having trouble sleeping. The doctor explains what is wrong and that there is one highly effective medication, which can have side effects involving stomach aches. In addition, the doctor explains that there is also a moderately effective medication, which has no side effects. The doctor asks Steve if he wants medication. Steve says 'yes' but he is not sure which. They discuss this some more and eventually Steve, with the doctor's help, decides on the moderately effective medication without side effects. The doctor prescribes the requested medication.

  4. [Tara] is always unhappy and has no energy to do anything. She gave birth to a baby girl two months ago. The doctor has told her that she may be suffering from post-natal depression. The doctor discussed her condition with her and then suggested that she could either try some medication or, if she prefers, talk to a counsellor.

  5. [Sarah] visits her doctor regularly because of back pain. She wants and has discussed alternative treatments with her doctor, such as special back exercises, acupuncture, herbs and change in lifestyle. When the pain got worse, the doctor adjusted the medication. He also agreed with her that consulting an alternative health care provider would be appropriate, but she should let him know what types of treatment they gave her.

  6. [Gabriel] has a history of chest pain. He usually goes to the local public hospital for his check-ups. One day he had severe pain in his chest and had to be rushed to a hospital. As soon as he got there, the doctors decided that they had to quickly run tests and take a blood sample. They did not ask for his permission because of the rush and because the tests were not dangerous or painful.

  7. [Bob] broke his arm a few months ago and had to have a series of X-rays. Initially, the doctors told him about his fractures and explained what treatment he was going to receive. On his last visit to the hospital, they gave him some more tests without explaining why they were doing them. After the tests were done, Bob asked what was happening. The doctor explained that the tests were just to check that the bones were growing straight.

  8. [Jasmina] has been feeling physically ill for a long-time. She goes to the hospital and describes her symptoms to the doctor. The doctor listens. Then, without giving any explanation, the doctor refers her to another doctor, who runs a number of tests. After the tests are completed, the doctor gives her pills and asks her to come back in a week. Jasmine was quite happy with not knowing any more details. She didn't want to have to worry about what her treatment was. She just wanted to know whether there were other cheaper medicines she could buy but the doctors didn't talk to her about this.

  9. [Mary] has a serious health problem and knows that she will soon die. Every time she visits her doctor she asks him about her treatment and how much her condition is deteriorating because she wants to know when she will die so she can plan the time she has left with her family. The doctor is reluctant to give her any information that will help her to plan her time with her family, even though she requests it.

  10. [Mohammed] has been very afraid of receiving injections throughout his life. One day, while travelling, he feels feverish and goes to a doctor. After examining him, the doctor does not give him any information about what he has found. The only thing the doctor says is that he will give him an injection for treatment. [Mohammed] tells the doctor that he does not like injections. In response, the doctor says 'do not worry, it will not hurt' and immediately gives the injection in [Mohammed]'s arm.