Abstract
Objective: To explore the relationship between personal characteristics of older adults with multiple chronic conditions (MCCs) and perceived shared decision making (SDM) resp. decisional conflict. Methods: In a video-observational study (N=213) data were collected on personal characteristics. The main outcomes were perceived level of SDM and decisional conflict. The mediating variable was participation in the SDM process. A two-step mixed effect multilinear regression and a mediation analysis were performed to analyze the data. Results: The mean age of the patients was 77.3 years and 56.3% were female. Health literacy (β.01, p<.001) was significantly associated with participation in the SDM process. Education (β=−2.43, p=.05) and anxiety (β=−.26, p=.058) had a marginally significant direct effect on the patients' perceived level of SDM. Education (β=12.12, p=.002), health literacy (β=−.70, p=.005) and anxiety (β=1.19, p=.004) had a significant direct effect on decisional conflict. The effect of health literacy on decisional conflict was mediated by participation in SDM. Conclusion: Health literacy, anxiety and education are associated with decisional conflict. Participation in SDM during consultations plays a mediating role in the relationship between health literacy and decisional conflict. Practice Implications: Tailoring SDM communication to health literacy levels is important for high quality SDM.