J. Med. Internet Res. - The effect of patient narratives on information search in a web-based breast cancer decision aid: an eye-tracking study.

Tópicos

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Resumo

CKGROUND: Previous research has examined the impact of patient narratives on treatment choices, but to our knowledge, no study has examined the effect of narratives on information search. Further, no research has considered the relative impact of their format (text vs video) on health care decisions in a single study.OBJECTIVE: Our goal was to examine the impact of video and text-based narratives on information search in a Web-based patient decision aid for early stage breast cancer.METHODS: Fifty-six women were asked to imagine that they had been diagnosed with early stage breast cancer and needed to choose between two surgical treatments (lumpectomy with radiation or mastectomy). Participants were randomly assigned to view one of four versions of a Web decision aid. Two versions of the decision aid included videos of interviews with patients and physicians or videos of interviews with physicians only. To distinguish between the effect of narratives and the effect of videos, we created two text versions of the Web decision aid by replacing the patient and physician interviews with text transcripts of the videos. Participants could freely browse the Web decision aid until they developed a treatment preference. We recorded participants' eye movements using the Tobii 1750 eye-tracking system equipped with Tobii Studio software. A priori, we defined 24 areas of interest (AOIs) in the Web decision aid. These AOIs were either separate pages of the Web decision aid or sections within a single page covering different content.RESULTS: We used multilevel modeling to examine the effect of narrative presence, narrative format, and their interaction on information search. There was a significant main effect of condition, P=.02; participants viewing decision aids with patient narratives spent more time searching for information than participants viewing the decision aids without narratives. The main effect of format was not significant, P=.10. However, there was a significant condition by format interaction on fixation duration, P<.001. When comparing the two video decision aids, participants viewing the narrative version spent more time searching for information than participants viewing the control version of the decision aid. In contrast, participants viewing the narrative version of the text decision aid spent less time searching for information than participants viewing the control version of the text decision aid. Further, narratives appear to have a global effect on information search; these effects were not limited to specific sections of the decision aid that contained topics discussed in the patient stories.CONCLUSIONS: The observed increase in fixation duration with video patient testimonials is consistent with the idea that the vividness of the video content could cause greater elaboration of the message, thereby encouraging greater information search. Conversely, because reading requires more effortful processing than watching, reading patient narratives may have decreased participant motivation to engage in more reading in the remaining sections of the Web decision aid. These findings suggest that the format of patient stories may be equally as important as their content in determining their effect on decision making. More research is needed to understand why differences in format result in fundamental differences in information search.

Resumo Limpo

ckground previous research examin impact patient narrat treatment choic knowledg studi examin effect narrat inform search research consid relat impact format text vs video health care decis singl studyobject goal examin impact video textbas narrat inform search webbas patient decis aid earli stage breast cancermethod fiftysix women ask imagin diagnos earli stage breast cancer need choos two surgic treatment lumpectomi radiat mastectomi particip random assign view one four version web decis aid two version decis aid includ video interview patient physician video interview physician distinguish effect narrat effect video creat two text version web decis aid replac patient physician interview text transcript video particip freeli brows web decis aid develop treatment prefer record particip eye movement use tobii eyetrack system equip tobii studio softwar priori defin area interest aoi web decis aid aoi either separ page web decis aid section within singl page cover differ contentresult use multilevel model examin effect narrat presenc narrat format interact inform search signific main effect condit p particip view decis aid patient narrat spent time search inform particip view decis aid without narrat main effect format signific p howev signific condit format interact fixat durat p compar two video decis aid particip view narrat version spent time search inform particip view control version decis aid contrast particip view narrat version text decis aid spent less time search inform particip view control version text decis aid narrat appear global effect inform search effect limit specif section decis aid contain topic discuss patient storiesconclus observ increas fixat durat video patient testimoni consist idea vivid video content caus greater elabor messag therebi encourag greater inform search convers read requir effort process watch read patient narrat may decreas particip motiv engag read remain section web decis aid find suggest format patient stori may equal import content determin effect decis make research need understand differ format result fundament differ inform search

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