Abstract Rationale Autonomy is a core ethical principle that drives patient involvement in care. However, it remains an unexplored principle in the ILD population, leaving a critical gap in understanding how to promote patient autonomy. Without understanding patients’ desires and preferences for autonomy, clinicians may lack crucial data to recognize and address the inequities facing patients with ILD. This study aimed to explore ILD patients’ preferences for autonomy and the associations between autonomy and sociodemographic factors, social connectedness, and isolation. Methods We conducted a cross-sectional survey of patients living with self-reported ILD recruited from the Pulmonary Fibrosis Foundation (PFF) Community Registry. Autonomy was measured through the Autonomy Preference Index (API), and self-efficacy was measured by the PROMIS Self-Efficacy for Managing Social Interactions scale. The independent variables include demographics, such as age, sex, race/ethnicity, marital status, and education, as well as clinical characteristics (pulmonary rehabilitation, disease duration). Additional measures included activities of daily living and depression screening. Descriptive statistics were calculated for all variables. Categorical variables were dichotomized, and total scores for each API subscale (decision-making and information-seeking) were calculated. Independent-samples t-tests examined associations between sociodemographic, self-efficacy, and autonomy variables. Results A total of 170 patients completed the API survey (86.9% were ≥60 years old, 59.4% female). Most live with another person (82.1%), and some participate in pulmonary rehabilitation (22.9%). There were high preferences for both decision-making (mean= 13.91, SD=2.31, range 4-20) and information-seeking (mean= 32.59, SD=2.88, range 7-35) (Figure 1). Educational level (no college= 8.82%; some college and above= 91.17%) was not associated with decision-making (p = .648) or information-seeking preferences (p = .912). Regarding diagnosis duration (≤5 years = 67.6%; ≥6 years = 32.4%), no statistically significant results were observed for decision-making (p = .328) or information-seeking (p = .430) preferences. 154 patients completed the PROMIS self-efficacy questionnaire. Although the autonomy preferences were high, the self-efficacy scores were approximately one standard deviation below the general population (mean= 41.38, SD= 7.90), suggesting lower self-efficacy. Conclusions Individuals living with ILD show strong overall preferences to be active in their care and informed about their health. The strikingly high preferences for autonomy stress the crucial desire for engagement among different sociodemographic and clinical backgrounds. Understanding and supporting patients’ autonomy preferences is essential to patient-centered care. Identifying and addressing barriers to autonomy, while promoting supportive factors, may foster patient engagement in their health and improve outcomes in ILD care. This abstract is funded by: None
Savvaides et al. (2026) studied this question.