An Examination of Factors on Adolescent Patients' Healthcare Decision-Making

• In Event: Poster Session 14
  In Poster Session: PS 14 Topic - Health, Growth, Injury

Abstract

Adolescents are at a transitional period between the dependence/vulnerability of childhood and the autonomy of adulthood (Grootens-Wiegers et al., 2017). They typically display decision-making competence that vary in patterns and levels across contexts. In the context of health management, adolescents' decision-making competence requires rigorous evaluation and support. In particular, the support of families and healthcare providers is needed in order to assist adolescents in navigating through challenges associated with hospitalization. Adolescents are also frequent users of the Internet, digital devices, and social media. How digital literacy plays a role in adolescent medical decision-making is unclear. Family, healthcare quality, and digital literacy may play a role in adolescent patients' decision-making (e.g., Miller & Drotar, 2007; Nangsangna & Da-Costa Vroom, 2019; Hinds et al., 2001) but how each is weighed in the process of decision-making, especially during adolescence should be further understood. The present study examined the relationships among the quality of healthcare, the parent-child relationship, accessing online health information, and adolescents’ decision-making competence.

Fifty adolescent patients and their parents completed an online questionnaire that measured the following variables on a 5-point Likert scale ranging from strongly disagree (1) to strongly agree (5): 1) adolescent decision-making competence, 2) involvement in decision-making, 3) online health information-seeking behaviors, 4) quality of care by healthcare provided, and 5) the quality of parent-child relationships. The preliminary analyses (Table 1) revealed a significant and positive correlation between involvement in health care decision-making and adolescents' decision-making competence (r = .52, p <0.01). Specifically, adolescent patients' higher levels of involvement in health care decision-making were associated with higher levels of reported decision-making self-confidence (r = .46, p <0.01), and lower levels of decision-making avoidance (r = -0.36, p < .01). Adolescents' decision-making competence was significantly correlated with quality of healthcare (r = 0.54, p <0.01), but not with parent-child relationship (r = 0.09, n.s.) or online health information seeking (r = .22, n.s.). That is, the role of parent-child relationship and online health information become minimal when adolescent patients make their medical decisions. Three themes emerged in participants' qualitative comments: 1) acquiring general knowledge of diagnosis, 2) learning more specific information about diagnosis, and 3) understanding the cause of illness and/or symptoms. Participants used the Internet to acquire, clarify, and learn information related to a health condition, diagnosis, or illness. The thematic analyses echoed the finding that ultimately, healthcare providers are the ones whom adolescent patients and their family would turn to for addressing unanswered questions and gaining a better understanding of their medical diagnoses before making important decisions on treatments and health management.

Authors

• Marialejandra Gutierrez, California State University - Los Angeles
  Presenting Author

• Yafen Lo, California State University - Los Angeles
  Non-Presenting Author

• Rita Goshert, Miller Children's and Women's Hospital Long Beach
  Non-Presenting Author