Cultural influences on shared decision-making among Asian Americans: A systematic review and meta-synthesis of qualitative studies.
Naomi Q P Tan, Kristin G Maki, Maria A López-Olivo and 2 others
PMID 36344320WHAT IT FOUND
Many Asian American patients want to be involved in discussions but prefer the provider to make the final decision.
Clinicians should ask separately about involvement in the process versus the final choice, and actively include family members in consultations.
Key findings
01Patients often distinguish between wanting to participate in the discussion and wanting to make the final medical decision themselves.
02Family involvement is central to decision-making for many patients, and excluding them can cause distress or be viewed as trying to turn the patient against their family.
03Language barriers and lack of professional interpreters frequently impede meaningful engagement, leading to misunderstandings of diagnoses and treatment options.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPsWhat it means for RNs
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What it does not show
The review aggregated all Asian American sub-groups, despite high diversity and known cultural variations between them. Chinese and Korean participants made up the majority of the study populations, limiting generalizability to other Asian American groups. Most included studies had female participants, so gender differences in SDM preferences may not be fully captured. The quality of the included qualitative studies varied, with many failing to address the influence of the researcher on the research. The studies were conducted in the U.S., so findings may not apply to Asian Americans in other contexts or to Asians in their home countries.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that a patient's preference to follow your recommendation means they do not want to be involved in the discussion. This review found that many patients want to be informed and respected in the process but prefer the provider to make the final decision. Also, do not assume family presence is optional; for many patients, it is central to their well-being and decision-making.