Health beliefs and expectations implicit in decision-making in a Hong Kong Chinese surgical population

Aims and objectives. This study was undertaken to explore health beliefs and expectations implicit in decision-making preferences of Chinese patients admitted for a surgical procedure in a regional hospital in Hong Kong. Background. Patient participation in decision-making about healthcare options is presently being advocated; however, its nature is complex and inadequately explored and understood. Method. Twenty surgical patients, 10 who desired active participation and 10 who desired passive participation, were interviewed about their reasons for their decision-making preference. Results. From thematic analysis of the interviews, 'trust' and 'certainty' emerged as important concepts. Of particular interest is how 'certainty' was construed differently by participants: participants who desired to be passive and have minimal participation in decision-making did not focus on 'certainty' as meaning the predictability of the treatment outcome, but rather 'certainty' related to trust and belief in the ability of the doctor to choose the best option for them. Alternatively, participants who desired greater participation in decision-making spoke much more about the 'certainty' of the treatment outcome. Conclusions. These findings suggest that patients' desire for participation in decision-making about surgery may be related to beliefs, expectations and understanding about certainty. Relevance to clinical practice. It could potentially benefit patients if this concept was explored further prior to patients undertaking decisions about undergoing surgery.