Methods Inf Med - Understanding behavioral intent to participate in shared decision-making in medically uncertain situations.

Tópicos

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Resumo

JECTIVE: This article describes the process undertaken to identify and validate behavioral and normative beliefs and behavioral intent based on the Theory of Reasoned Action (TRA) and applied to men between the ages of 45 and 70 in the context of their participation in shared decision-making (SDM) in medically uncertain situations. This article also discusses the preliminary results of the aforementioned processes and explores potential future uses of this information that may facilitate greater understanding, efficiency and effectiveness of clinician-patient consultations.MATERIALS AND METHODS: Twenty-five male subjects from the Philadelphia community participated in this study. Individual semi-structure patient interviews were conducted until data saturation was reached. Based on their review of the patient interview transcripts, researchers conducted a qualitative content analysis to identify prevalent themes and, subsequently, create a category framework. Qualitative indicators were used to evaluate respondents' experiences, beliefs, and behavioral intent relative to participation in shared decision-making during medical uncertainty.RESULTS: Based on the themes uncovered through the content analysis, a category framework was developed to facilitate understanding and increase the accuracy of predictions related to an individual's behavioral intent to participate in shared decision-making in medical uncertainty. The emerged themes included past experience with medical uncertainty, individual personality, and the relationship between the patient and his physician. The resulting three main framework categories include 1) an individual's Foundation for the concept of medical uncertainty, 2) how the individual Copes with medical uncertainty, and 3) the individual's Behavioral Intent to seek information and participate in shared decision-making during times of medically uncertain situations.DISCUSSION: The theme of Coping (with uncertainty) emerged as a particularly critical behavior/characteristic amongst the subjects. By understanding a subject's disposition with regard to coping, researchers were better able to make connections between a subject's prior experiences, their knowledge seeking activities, and their intent to participate in SDM. Despite having information and social support, the subjects still had to cope with the idea of uncertainty before determining how to proceed with regard to shared decision-making. In addition, the coping category reinforced the importance of information seeking behaviors and preferences for shared decision-making.CONCLUSIONS: This study applies and extends the field of behavioral and health informatics to assist medical practice and decision-making in situations of medical uncertainty. More specifically, this study led to the development of a category framework that facilitates the identification of an individual's needs and motivational factors with regard to their intent to participate in shared decision-making in situations of medical uncertainty.

Resumo Limpo

jectiv articl describ process undertaken identifi valid behavior normat belief behavior intent base theori reason action tra appli men age context particip share decisionmak sdm medic uncertain situat articl also discuss preliminari result aforement process explor potenti futur use inform may facilit greater understand effici effect clinicianpati consultationsmateri method twentyf male subject philadelphia communiti particip studi individu semistructur patient interview conduct data satur reach base review patient interview transcript research conduct qualit content analysi identifi preval theme subsequ creat categori framework qualit indic use evalu respond experi belief behavior intent relat particip share decisionmak medic uncertaintyresult base theme uncov content analysi categori framework develop facilit understand increas accuraci predict relat individu behavior intent particip share decisionmak medic uncertainti emerg theme includ past experi medic uncertainti individu person relationship patient physician result three main framework categori includ individu foundat concept medic uncertainti individu cope medic uncertainti individu behavior intent seek inform particip share decisionmak time medic uncertain situationsdiscuss theme cope uncertainti emerg particular critic behaviorcharacterist amongst subject understand subject disposit regard cope research better abl make connect subject prior experi knowledg seek activ intent particip sdm despit inform social support subject still cope idea uncertainti determin proceed regard share decisionmak addit cope categori reinforc import inform seek behavior prefer share decisionmakingconclus studi appli extend field behavior health informat assist medic practic decisionmak situat medic uncertainti specif studi led develop categori framework facilit identif individu need motiv factor regard intent particip share decisionmak situat medic uncertainti

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