BMC Med Inform Decis Mak - Do personal stories make patient decision aids more effective? A critical review of theory and evidence.

Tópicos

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Resumo

CKGROUND: Patient decision aids support people to make informed decisions between healthcare options. Personal stories provide illustrative examples of others' experiences and are seen as a useful way to communicate information about health and illness. Evidence indicates that providing information within personal stories affects the judgments and values people have, and the choices they make, differentially from facts presented in non-narrative prose. It is unclear if including narrative communications within patient decision aids enhances their effectiveness to support people to make informed decisions.METHODS: A survey of primary empirical research employing a systematic review method investigated the effect of patient decision aids with or without a personal story on people's healthcare judgements and decisions. Searches were carried out between 2005-2012 of electronic databases (Medline, PsycINFO), and reference lists of identified articles, review articles, and key authors. A narrative analysis described and synthesised findings.RESULTS: Of 734 citations identified, 11 were included describing 13 studies. All studies found participants' judgments and/or decisions differed depending on whether or not their decision aid included a patient story. Knowledge was equally facilitated when the decision aids with and without stories had similar information content. Story-enhanced aids may help people recall information over time and/or their motivation to engage with health information. Personal stories affected both "system 1" (e.g., less counterfactual reasoning, more emotional reactions and perceptions) and "system 2" (e.g., more perceived deliberative decision making, more stable evaluations over time) decision-making strategies. Findings exploring associations with narrative communications, decision quality measures, and different levels of literacy and numeracy were mixed. The pattern of findings was similar for both experimental and real-world studies.CONCLUSIONS: There is insufficient evidence that adding personal stories to decision aids increases their effectiveness to support people's informed decision making. More rigorous research is required to elicit evidence about the type of personal story that a) encourages people to make more reasoned decisions, b) discourages people from making choices based on another's values, and c) motivates people equally to engage with healthcare resources.

Resumo Limpo

ckground patient decis aid support peopl make inform decis healthcar option person stori provid illustr exampl other experi seen use way communic inform health ill evid indic provid inform within person stori affect judgment valu peopl choic make differenti fact present nonnarr prose unclear includ narrat communic within patient decis aid enhanc effect support peopl make inform decisionsmethod survey primari empir research employ systemat review method investig effect patient decis aid without person stori peopl healthcar judgement decis search carri electron databas medlin psycinfo refer list identifi articl review articl key author narrat analysi describ synthesis findingsresult citat identifi includ describ studi studi found particip judgment andor decis differ depend whether decis aid includ patient stori knowledg equal facilit decis aid without stori similar inform content storyenhanc aid may help peopl recal inform time andor motiv engag health inform person stori affect system eg less counterfactu reason emot reaction percept system eg perceiv delib decis make stabl evalu time decisionmak strategi find explor associ narrat communic decis qualiti measur differ level literaci numeraci mix pattern find similar experiment realworld studiesconclus insuffici evid ad person stori decis aid increas effect support peopl inform decis make rigor research requir elicit evid type person stori encourag peopl make reason decis b discourag peopl make choic base anoth valu c motiv peopl equal engag healthcar resourc

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