Table 2 Quotations: Decision-making

A. Minimal patient involvement

My decision [to take warfarin]? It was the doctor's decision. (P5)

I had nothing to say [regarding decision to initiate warfarin]. If the doctor tells me something, I do it. (P17)

Q: What influenced your decision to take the drug?

A: Well, because I was told to.

Q: The main reason is that it was the physician's recommendation?

A: Yes. (P20)

I don't recall him [the physician] saying anything much. He said a lot of things when he examined me first, and he put me up in the ward overnight, then he started with the medications. That's all there was to it...Not really, no [no much discussion on reasons to start warfarin]. He just said that, "This is what medication we're going to put you on for the myopathy." That was it. (P11)

B. Trust of physicians

I just figured the doctor knows best... (P1)

A: No [trouble to decide to take warfarin], because I knew nothing about it. My doctor, as far as I know, is very competent so...

Q: So you are taking it basically because the doctor told you to?

A: That's right. (P6)

I'm at this hospital and it's got a very good reputation... Doctor knows best, I guess. They know exactly what you have to do for it, and they did it. (P14)

I can recall that I had no objection. I said, "You are the experts, you are the doctors. If I get any help, I mostly will appreciate it.".... I don't think I would trust myself that much [to make the right decision]. (P15)

C. Constraining effect of circumstances

When I went into the [clinic] to see my doctor, they admitted me to the cardiac emergency, and they kept me there all day ... I was in for just about a week. ... and when I was discharged the doctors explained that they were putting me on to certain medications, and Coumadin was one of them. (P10)

I had congestive heart failure, that's what I was in hospital for. I don't know what I was on when I was in hospital, but when I came out I had a whole slew of medications and Coumadin was one of them. (P5)

I had lymphoma, and then I had a bone marrow transplant for lymphoma, and I had my spleen taken out, and I started getting deep vein thrombosis. Then I had a pulmonary embolism at one point and they started me on it [warfarin] then... I had just about every complication in the book, and this [thrombosis] was one of them. I think it was around that time, or within a year after the thromboses started, they gave me warfarin. (P13)

The surgeon said I had to take it, basically. I don't like taking pills, so when I went in to get my one valve replaced, they gave me – they persuaded me – and I agreed to trying out something new that had just been approved. The reason for doing that was that I would not have to take Coumadin... Unfortunately, however, one of my other valves blew when I was in there [during surgery], so I got two for the price of one, and then there was no question I had to go on a blood thinner. (P19)