The development of picture cards and their use in ascertaining characteristics of Chinese surgical patients’ decision-making preferences

Aim This exploratory pilot study developed and tested the validity of picture cards as a strategy to ascertain patients’ desired participation in decision making. These were then used to ascertain characteristics of Hong Kong Chinese patients’ decision-making preferences for surgery.

Validation of tool Two sets of analyses tested the validity of picture cards in an Australian and Hong Kong Chinese population. First, the ratings of the two groups of participants using the picture cards for three scenarios (severe, moderate and mild medical conditions) were correlated with mean ratings of three decision-making subscales of a self-report questionnaire for the three scenarios. Second, a 3 (Scenario) × 2 (Ethnic Group) mixed anova examined whether the picture cards are sensitive to differences relating to severity of medical conditions and ethnicity.

Setting and participants A convenience sample of initially 35 Hong Kong and 24 Australian patients was used to validate the picture card tool. A convenience sample of a further 186 Hong Kong Chinese surgical inpatients used the tool.

Design Participants selected the picture card that best represented their decision-making preference.

Main variables Demographic factors, prior knowledge, nature of surgery and preference for participation in decision making.

Results Significant correlations were made between the questionnaire and the picture card tool. Using the tool, a significant difference was found between males’ and females’ decision-making preference, yet, no significant difference was found with respect to type or previous surgical operation.

Conclusion Results indicate that demographic variables do have an effect, however undergoing previous surgery or type of surgery does not affect decision-making preference.