Patient expectancy of shared decision making according to ego states in primary care

Shared decision making (SDM) is a clinical approach that includes presenting options to the patient, giving detailed information about these options, and actively participating in the decision-making process. Implementation of SDM, which is a component of family medicine core competencies, patient-centered care, will provide positive clinical outcomes in primary care. In our country, no study on patient perspective was found in SDM process. The aim of this study is to investigate the SDM expectations of patients in primary care according to their ego status. The study was conducted at Dokuz Eylul University Family Medicine Centers (FMC). The research was carried out in two stages.. In the first phase, in the scope of the methodological part of the study, it was aimed to develop a data form related to patient aspects in SDM and it was evaluated with factor analysis for construct validity and Cronbach alpha coefficient for reliability. A 32-likert-type question about SDM was formed and validated as ''Primary Care Patients' Expectancy for Shared Decision Making Questionnaire. (Keizer-Meyer-Olkin 0,986, Cronbach alpha 0,98) A cross-sectional study was carried out in the second stage of the study, the number of samples was determined as 402 patients with 50% prevalence, 95% confidence level and 0.05 error margin. ''Primary Care Patients' Expectancy for Shared Decision Making Questionnaire'', Ego States Scale (ESS) and demographic data form were applied. The data of the study were analyzed by IBM SPSS (statistical package for social sciences) 22.0 package program. In the statistical evaluation of the data; descriptive analyzes (mean, standard deviation and percentage), chi square analysis, and logistic regression were used. There is no significant statistical relationship between the patients' ego states and the expectations of shared decision making. (p=0,567). Patients' age (p=0,020), profession (p=0,020), inhabitancy period in recent location (p=0,014), chronic disease (0,010), place of birth (p = 0,027), psychiatric disorder (p=0,006), number of people living in the same house (0,06) and educational status (p=0,039) had a significant effect on patient expectancy in shared decision making. According to the logistic regression analysis findings, the presence of a chronic disease increases the SDM expectancy by 3,931 times compared to the non-existent patients. On the other hand, having a history of psychiatric illness increases the expectation of SDM 3.573 times. In those living with 3 or more people in the same house, the expectation of SDM increased by 2,224 times compared to those living with 2 or less people. According to the results of this study, it should be considered that SDM expectancy of primary care patients is effected by socio-demographic characteristics of patients and we need further researches to understand the role of psychological phenomenons in SDM. Keywords: Primary care, shared decision making, family medicine, ego states, patient centered care