Chapter 9: Family-Centered Decision-Making About Type 2 Diabetes Mellitus Among Koreans

The purpose of this study is to investigate Koreans' preferences for FCDM versus SDM and explored the influence of Asian cultural values on decision-making in the context of managing chronic illnesses, such as type 2 diabetes mellitus (T2DM). Shared decision-making (SDM) emphasizes collaboration between providers and service recipients to decide on the best treatment options. However, it may not fully account for the role of families in managing chronic illness, particularly for people from Eastern cultural backgrounds who value active participation from their families in decisions. In response, family-centered decision-making (FCDM) has been proposed as an alternative approach. Using a vignette experiment design, data (n = 316) were collected from Koreans in the US and in Korea who were randomly presented with either SDM or FCDM processes for reaching T2DM treatment decisions. In addition to demographic information, participants reported on three dimensions of their decision-making experience: satisfaction, perceived effectiveness, and perspective-taking. They also rated their Asian cultural values and familiarity with T2DM. Results show better satisfaction, perceived effectiveness, and perspective taking for FCDM compared to SDM when examined in context of treatment types and perceived illness severity. Moderation effects were found for familiarity of illness, with familiarity effects varying by perceived severity. Study findings provided some evidence in favor of FCDM in Asian communities addressing the disabilities and chronic illness of a family member. Although the current study investigated treatment decisions for T2DM during doctor's visits, FCDM has shown potential to be applied in other service settings.