{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T06:25:55Z","timestamp":1775197555645,"version":"3.50.1"},"reference-count":28,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2021,10,12]],"date-time":"2021-10-12T00:00:00Z","timestamp":1633996800000},"content-version":"unspecified","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100017014","name":"Centro de Investiga\u00e7\u00e3o em Tecnologias e Servi\u00e7os de Sa\u00fade","doi-asserted-by":"publisher","award":["UIDB\/4255\/2020"],"award-info":[{"award-number":["UIDB\/4255\/2020"]}],"id":[{"id":"10.13039\/501100017014","id-type":"DOI","asserted-by":"publisher"}]},{"name":"H4A Primary Healthcare Research Network Scholars program"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,8,31]]},"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To assess patients\u2019 preferred roles in healthcare-related decision-making in a representative sample of the Portuguese population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Population-based nationwide cross-sectional study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting and participants<\/jats:title>\n                  <jats:p>A sample of Portuguese people 20 years or older were interviewed face-to-face using a questionnaire with the Problem-Solving Decision-Making scale.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcomes<\/jats:title>\n                  <jats:p>The primary outcome was patients\u2019 preferred role for each vignette of the problem-solving decision-making scale. Sociodemographic factors associated with the preferred roles were the secondary outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>599 participants (20\u201399 years, 53.8% women) were interviewed. Three vignettes of the Problem-Solving Decision-Making scale were compared: <jats:italic>morbidity<\/jats:italic>, <jats:italic>mortality<\/jats:italic> and <jats:italic>quality of life<\/jats:italic>. Most patients preferred a passive role for both the problem-solving and decision-making components of the scale, particularly for the <jats:italic>mortality vignette<\/jats:italic> (66.1% in the analysis of the three vignettes), although comparatively more opted to share decision in the decision-making component. For the <jats:italic>quality of life vignette<\/jats:italic>, a higher percentage of patients wanted a shared role (44.3%) than with the other two vignettes. In the problem-solving component, preferences were significantly associated with area of residence (p&lt;0.001) and educational level (p=0.013), while in the decision-making, component preferences were associated with age (p=0.020), educational level (p=0.015) and profession (p&lt;0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In this representative sample of the Portuguese mainland population, most patients preferred a practitioner-controlling role for both the problem-solving and decision-making components. In a life-threatening situation, patients were more willing to let the doctor decide. In contrast, in a less serious situation, there is a greater willingness to participate in decision-making. We have found that shared decision-making is more acceptable to better-educated patients in the problem-solving component and to people who are younger, higher educated and employed, in the decision-making component.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-048488","type":"journal-article","created":{"date-parts":[[2021,10,13]],"date-time":"2021-10-13T03:27:37Z","timestamp":1634095657000},"page":"e048488","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["What role do patients prefer in medical decision-making?: a population-based nationwide cross-sectional study"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8168-0009","authenticated-orcid":false,"given":"Micaela","family":"Greg\u00f3rio","sequence":"first","affiliation":[{"name":"MEDCIDS - Department of Community Medicine, Information and Decision in Health, Faculty of Medicine, University of Porto, 4099-002 Porto, Portugal"},{"name":"#H4A Primary Healthcare Research Network, Porto, Portugal"}]},{"given":"Andreia","family":"Teixeira","sequence":"additional","affiliation":[{"name":"MEDCIDS - Department of Community Medicine, Information and Decision in Health, Faculty of Medicine, University of Porto, 4099-002 Porto, Portugal"},{"name":"Centre for Health Technology and Services Research (CINTESIS), Universidade do Porto, Porto, Portugal"},{"name":"AdiT-LAB, Instituto Polit\u00e9cnico de Viana do Castelo, Rua Escola Industrial e Comercial Nun' \u00c1lvares, 4900-347 Viana do Castelo, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4032-9594","authenticated-orcid":false,"given":"Teresa","family":"Henriques","sequence":"additional","affiliation":[{"name":"MEDCIDS - Department of Community Medicine, Information and Decision in Health, Faculty of Medicine, University of Porto, 4099-002 Porto, Portugal"},{"name":"Centre for Health Technology and Services Research (CINTESIS), Universidade do Porto, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8782-0260","authenticated-orcid":false,"given":"Ros\u00e1lia","family":"P\u00e1scoa","sequence":"additional","affiliation":[{"name":"MEDCIDS - Department of Community Medicine, Information and Decision in Health, Faculty of Medicine, University of Porto, 4099-002 Porto, Portugal"},{"name":"#H4A Primary Healthcare Research Network, Porto, Portugal"},{"name":"Centre for Health Technology and Services Research (CINTESIS), Universidade do Porto, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2604-9369","authenticated-orcid":false,"given":"Sofia","family":"Baptista","sequence":"additional","affiliation":[{"name":"MEDCIDS - Department of Community Medicine, Information and Decision in Health, Faculty of Medicine, University of Porto, 4099-002 Porto, Portugal"},{"name":"#H4A Primary Healthcare Research Network, Porto, Portugal"},{"name":"Centre for Health Technology and Services Research (CINTESIS), Universidade do Porto, Porto, Portugal"}]},{"given":"Rosa","family":"Carvalho","sequence":"additional","affiliation":[{"name":"#H4A Primary Healthcare Research Network, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8561-5167","authenticated-orcid":false,"given":"Carlos","family":"Martins","sequence":"additional","affiliation":[{"name":"MEDCIDS - Department of Community Medicine, Information and Decision in Health, Faculty of Medicine, University of Porto, 4099-002 Porto, Portugal"},{"name":"#H4A Primary Healthcare Research Network, Porto, Portugal"},{"name":"Centre for Health Technology and Services Research (CINTESIS), Universidade do Porto, Porto, Portugal"}]}],"member":"239","published-online":{"date-parts":[[2021,10,12]]},"reference":[{"key":"2025101812365138000_11.10.e048488.1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-98-2-243"},{"key":"2025101812365138000_11.10.e048488.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1109283"},{"key":"2025101812365138000_11.10.e048488.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2003.09.011"},{"key":"2025101812365138000_11.10.e048488.4","article-title":"A is for aphorism","volume":"41","author":"Cooke","year":"2012","journal-title":"Australian Family Physician"},{"key":"2025101812365138000_11.10.e048488.5","doi-asserted-by":"crossref","unstructured":"Stacey D , L\u00e9gar\u00e9 F , Lewis K , et al . 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