Association of physicians' Big Five personality traits with shared decision-making in patients with SLE

Abstract

Objectives Recent European League Against Rheumatism guidelines highlight the importance of shared decision-making (SDM) in SLE treatment. This study investigated the relationship between physicians' personality traits and patient-rated SDM. Methods Using baseline data from the Trust Measurements for Physicians and Patients with SLE (TRUM2-SLE) study, physicians' personality traits were assessed by the Japanese version of the 10-Item Personality Inventory (TIPI-J) scale (scores of 1-7 points each), while SDM was evaluated using the patient-reported nine-item SDM Questionnaire (SDM-Q-9) scale (total 0-100 points). Linear mixed-effects models with cluster-robust variance estimation analysed the association between TIPI-J scores and SDM-Q-9 scores. A cluster analysis was also performed to group physicians based on personality patterns, and the association between these clusters and SDM-Q-9 was evaluated. Results Among 493 patients, the median SDM-Q-9 score was 75.6. Among 43 physicians, the median TIPI-J scores were as follows: extraversion, 4.0; agreeableness, 5.0; conscientiousness, 3.0; neuroticism, 3.5 and openness, 4.0. Conscientiousness (β = -1.67; 95% CI, -3.02 to -0.33) and neuroticism (β = -2.06; 95% CI -4.08 to -0.04) correlated negatively with SDM-Q-9 scores. A clustering analysis identified three physician groups; those in Cluster 2, characterized by low conscientiousness and neuroticism and labelled 'lower perfectionism', had significantly higher SDM-Q-9 scores than those in Clusters 1 and 3. Conclusion A physician's perfectionist tendencies may be a barrier to the SDM process with patients.