The OPTION Scale: Measuring Patients’ Perceptions of Shared Decision-Making in the Kingdom of Saudi Arabia

Figures & data

Table 1 Variable Distribution

	Strongly Disagree (%)	Disagree (%)	Neutral (%)	Agree (%)	Strongly Agree (%)
1. The physician draws attention to certain problems that requires my decisions.	11 (3.8)	22 (7.6)	45 (15.5)	173 (59.5)	40 (13.7)
2. The physician indicates there are more than one option to deal with my problem.	9 (3.1)	30 (10.3)	27 (9.3)	171 (58.8)	54 (18.6)
3. The physician assists me in making a decision.	6 (2.1)	22 (7.6)	20 (6.9)	183 (62.9)	60 (20.6)
4. The physician lists all treatment options including “not to take any action.”	12 (4.1)	48 (16.5)	43 (14.8)	150 (51.5)	38 (13.1)
5. The physician explains the pros and cons of my decision.	11 (3.8)	32 (11)	30 (10.3)	157 (54)	61 (21)
6. The physician explores my expectation on my way of managing the problem.	12 (4.1)	42 (14.4)	58 (19.9)	153 (52.6)	26 (8.9)
7. The physician explores my fears on my way of managing the problem.	7 (2.4)	44 (15.1)	62 (21.3)	146 (50.2)	32 (11)
8. The physician ensures my understanding of the provided information.	11 (3.8)	35 (12)	42 (14.4)	153 (52.6)	50 (17.2)
9. The physician enables me to ask questions during the decision-making process.	9 (3.1)	22 (7.6)	33 (11.3)	154 (52.9)	73 (25.1)
10. The physician indicates my best level of involvement in decision-making.	5 (1.7)	29 (10)	55 (18.9)	157 (54)	45 (15.5)
11. The physician indicates the need to a shared decision-making.	7 (2.4)	33 (11.3)	62 (21.3)	144 (49.5)	45 (15.5)
12. The physician indicates the necessity of re-evaluating the decision.	7 (2.4)	29 (10)	51 (17.5)	151 (51.9)	53 (18.2)

Table 2 Associations Between Mean Shared Decision-Making Score and Clinic and Physician Information

Variables	n= 291 (%)	Mean (SD)	Test
Type of hospital/clinic from which patient received care			f = 1.291 P = 0.278
Private hospital	136 (47)	43.5 (9)
Government hospital	113 (39)	44.5 (9)
Teaching hospital	16 (5)	47.0 (10)
Military hospital	26 (9)	46.0 (6)
Clinic			f = 2.163 P = 0.009
Emergency	73 (25)	44.4 (8)
Internal medicine	24 (8)	38.3 (11)
Surgery	15 (5)	47.3 (8)
Neurology & Neurosurgery	9 (3)	45.8 (8)
Cardiology & Cardiac Surgery	4 (1)	40.8 (11)
Urology	7 (2)	42.7 (9)
Pediatrics	14 (5)	47.9 (7)
Obstetrics & Gynecology	39 (13)	46.3 (8)
Orthopedic	19 (7)	43.9 (11)
Ophthalmology	4 (1)	44.3 (11)
Dermatology	15 (5)	44.5 (10)
ENT	19 (7)	40.0 (10)
Dentistry	26 (9)	45.7 (6)
GP	11 (4)	43.6 (4)
Otherª	12 (4)	49.7 (5)
Physician’s gender?			t = −2.732 P = 0.007
Male	172 (59)	43.3 (10)
Female	119 (41)	46.0 (7)

Note: ªOther clinics include endocrine, chronic disease, hematology, and oncology clinics.

Figure 1 Shared decision-making score and type of clinic.

Table 3 Associations Between Mean Shared Decision-Making Score and Patients’ Demographic Characteristics

Variables	n=291 (%)	Mean (SD)	Test (P-value)	Variables	n=291 (%)	Mean (SD)	Test (P-value)
Patient’s gender				Availability of health insurance
Male	100 (34)	41.8 (9)	t = −3.644 (0.0001)
				Yes	130 (45)	43.7 (10)	t = −1.278 P = 0.202
Female	191 (66)	45.7 (9)
				No	161 (55)	45.0 (8)
Patient’s age				Patient’s perception of his/her general health
19–24 years	21 (7)	44.5 (7)	f = 1.542 (0.142)
25–29 years	26 (9)	41.9 (9)
30–34 years	48 (16)	44.4 (9)		Excellent	98 (34)	44.1 (10)	f = 0.370 P = 0.830
35–39 years	49 (17)	42.3 (10)		Very good	102 (35)	45.0 (9)
40–44 years	31(11)	44.6 (9)		Good	81 (28)	44.4 (9)
45–49 years	40 (14)	45.6 (8)		Bad or very bad	3 (1)	39.7 (8)
50–54 years	42 (14)	45.9 (9)		Did not want to disclose	5 (2)	44.2 (2)
55–59 years	19 (7)	43.8 (8)
> 60 years	14 (5)	49.8 (5)		Missing	2 (1)	-
Missing	1 (0)	-
Patient’s nationality				Patient’s profession
Saudi	285 (98)	44.4 (9)	t = 0.018 (0.985)	Unemployed	82 (28)	45.6 (8)	f = 2.927 (0.055)
Non-Saudi	6 (2)	44.3 (5)
				In the healthcare sector	35 (12)	41.3 (11)
				Non-health-related sectors	174 (60)	44.4 (9)
Patient’s highest educational level				Patient’s marital status
				Single	44 (15)	42.6 (9)	f = 0.804 (0.523)
Primary	0 (0)	-	f = 1.247 (0.291)
				Married	230 (79)	44.9 (9)
Intermediate	4 (1)	48.8 (3)
				Divorced	7 (2)	44.0 (11)
High school	24 (8)	46.8 (7)		Widowed	7 (2)	4.9 (6)
Diploma	29 (10)	45.1 (10)		Did not want to disclose	3 (1)	43.0 (12)
Bachelor	183 (63)	44.4 (10)
Higher education	50 (17)	42.6 (11)
Missing	1 (0)	-
Patient’s current living region (Province)				Type of health insurance
				A or VIP	54 (19)	44.0 (9)	f = 0.587 P = 0.710
Middle	17 (6)	42.0 (10)	f = 3.613 P = 0.007	B	29 (10)	42.8 (10)
Western	14 (5)	44.8 (9)
Eastern	257 (88)	24.0 (13)		C	12 (4)	44.9 (10)
Southern	2 (1)	24.0 (13)
Northern	1 (0)	-		D	6 (2)	40.8 (14)
				No insurance	161 (55)	45.0 (8)
				Otherª	28 (10)	43.7 (9)
				Missing	1 (0)	-

Notes: ªOther types of health insurance included Aramco, company insurance, security forces hospital insurance, and Royal Commission insurance in Jubail. Some patients did not know what type of insurance they had.

Table 4 Linear Regression Analysis to Account for the Magnitude of Association of the Shared Decision-Making Score and Other Variables in the Study

Variables	Coef.	Std. Err.	t	P>|t|	95% Conf. Interval
					Upper	Lower
Patient’s gender  Female	2.905	1.155	2.52	0.012	0.631	5.180
Physician’s gender  Female	1.387	1.161	1.19	0.234	−0.900	3.673
Type of Clinic
Internal medicine	−5.147	1.984	−2.59	0.01	−9.054	−1.24
Surgery	3.223	2.383	1.35	0.177	−1.469	7.914
Neurology and Neurosurgery	0.926	2.957	0.31	0.754	−4.895	6.748
Urology	−0.375	3.340	−0.11	0.911	−6.950	6.200
Pediatric	4.906	2.485	1.97	0.049	0.014	9.797
Obstetrics & Gynecology	0.639	1.767	0.36	0.718	−2.839	4.117
Orthopedic	−0.190	2.186	−0.09	0.931	−4.493	4.114
Ophthalmology	0.499	4.313	0.12	0.908	−7.992	8.991
Dermatology	−0.760	2.376	−0.32	0.749	−5.439	3.918
ENT	−4.056	2.166	−1.87	0.062	−8.321	0.209
Dentistry	1.328	1.910	0.7	0.488	−2.433	5.088
Others	4.505	2.613	1.72	0.086	−0.640	9.650
GP	−0.592	2.703	−0.22	0.827	−5.913	4.730
Cardiology and cardiac surgery	−2.307	4.322	−0.53	0.594	−10.817	6.202
Living Region
Western Province	1.432	3.072	0.47	0.642	−4.617	7.480
Eastern Province	3.112	2.122	1.47	0.144	−1.065	7.290
Southern Province	−14.791	6.315	−2.34	0.02	−27.223	−2.359
Northern Boarder	−9.763	8.740	−1.12	0.265	−26.970	7.444
Cons.	39.218	2.356	16.65	0	34.580	43.857

Notes: Summary: Number of obs= 291, SS= 3941.25144, Df= 20, MS= 197.062572. Model: Prob > F = 0.0001, R-squared = 0.1736, Adj R-squared= 0.1124. Outcome variable: Shared Decision-Making score. The bold font in the numbers indicate a significant association.