Shared Decision-Making in Anesthesia in the Indian Context: A Cross-Sectional Study.

Background Patient participation in the decision-making process is an important component of modern evidence-based medicine. In this study, we assessed the involvement of patients in making a decision while choosing an anesthesia technique for elective surgery of a single limb. Methodology This cross-sectional study at a tertiary care institute enrolled patients planned for elective surgery of a single limb. Questionnaires were employed to assess patients' demographic details and the participants' preferred technique of anesthesia for the surgery. On completion of pre-anesthesia evaluation, standardized questionnaires (Shared Decision-Making Questionnaire (SDM)-Q-9 for patients and SDM-Q-Doc for doctors) were employed to assess the involvement in deciding anesthesia technique from both the patients' and doctors' perspectives. Median and interquartile range or standard deviation and mean were used to summarize quantitative variables where appropriate. The analysis of variance test was used to compare the mean scores in different categories. Categorical variables were compared using the chi-square test. Results Most patients (93, 60%) preferred a passive role in decision-making regarding the technique of anesthesia. General anesthesia was preferred for both upper and lower limb surgeries. However, the preference for spinal anesthesia increased (56, 47.8% to 95, 81.1%) among those planned for lower limb surgery after the pre-anesthesia evaluation was completed. Patients reported a higher perceived level of shared decision-making (84.44%, 38 out of 45 score) compared to the clinicians' perspective (71.11%, 32 out of 45 score). Conclusions While evaluating shared decision-making regarding anesthesia technique in Indian patients, we found that most patients preferred a passive role, and the perceived level of shared decision-making was found to be higher among patients compared to clinicians.