scholarly journals A Typology of Patients Based on Decision-Making Styles: Cross-Sectional Survey Study (Preprint)

2019 ◽  
Author(s):  
Mary Anne FitzPatrick ◽  
Alexandra Claudia Hess ◽  
Lynn Sudbury-Riley ◽  
Peter Johannes Schulz
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Information ◽  
Health Professionals ◽  
Online Health Information ◽  
Cross Sectional ◽  
Patient Decision Making ◽  
Health Care Practitioners ◽  
Patient Decision ◽  
Decision Making Styles

BACKGROUND Although previous research shows broad differences in the impact of online health information on patient-practitioner decision making, specific research is required to identify and conceptualize patient decision-making styles related to the use of online health information and to differentiate segments according to the influence of online information on patient decision making and interactions with health professionals. OBJECTIVE This study aimed to investigate patients’ decision making in relation to online health information and interactions with health care practitioners. We also aimed to present a typology of patients based on significant differences in their decision making. METHODS We applied a large-scale cross-sectional research design using a survey. Data, generated using a questionnaire that was administered by companies specializing in providing online panels, were collected from random samples of baby boomers in the United Kingdom, the United States, and New Zealand. The total sample comprised 996 baby boomers born between 1946 and 1964, who had used the internet in the previous 6 months to search for and share health-related information. Data were analyzed using hierarchical cluster analysis and confirmatory factor analysis, as well as one-way analysis of variance, chi-square tests, and paired sample <italic>t</italic> tests. RESULTS Analyses identified 3 key decision-making styles that served as the base for 4 unique and stable segments of patients with distinctive decision-making styles: the Collaborators (229/996, 23.0%), the Autonomous-Collaborators (385/996, 38.7%), the Assertive-Collaborators (111/996, 11.1%), and the Passives (271/996, 27.2%). Profiles were further developed for these segments according to key differences in the online health information behavior, demographics, and interactional behaviors of patients. The typology demonstrates that collaborative decision making is dominant among patients either in its pure form or in combination with autonomous or assertive decision making. In other words, most patients (725/996, 72.8%) show significant collaboration in their decision making with health care professionals. However, at times, patients in the combination Autonomous-Collaborative segment prefer to exercise individual autonomy in their decision making, and those in the combination Assertive-Collaborative segment prefer to be assertive with health professionals. Finally, this study shows that a substantial number of patients adopt a distinctly passive decision-making style (271/996, 27.2%). CONCLUSIONS The patient typology provides a framework for distinguishing practice-relevant and addressable segments with important implications for health care practitioners, including better-targeted communication programs for patients and more successful outcomes for health care services in the long term.

scholarly journals A Typology of Patients Based on Decision-Making Styles: Cross-Sectional Survey Study

10.2196/15332 ◽  
2019 ◽  
Vol 21 (11) ◽  
pp. e15332 ◽  
Author(s):  
Mary Anne FitzPatrick ◽  
Alexandra Claudia Hess ◽  
Lynn Sudbury-Riley ◽  
Peter Johannes Schulz
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Information ◽  
Health Professionals ◽  
Online Health Information ◽  
Cross Sectional ◽  
Patient Decision Making ◽  
Health Care Practitioners ◽  
Patient Decision ◽  
Decision Making Styles

Background Although previous research shows broad differences in the impact of online health information on patient-practitioner decision making, specific research is required to identify and conceptualize patient decision-making styles related to the use of online health information and to differentiate segments according to the influence of online information on patient decision making and interactions with health professionals. Objective This study aimed to investigate patients’ decision making in relation to online health information and interactions with health care practitioners. We also aimed to present a typology of patients based on significant differences in their decision making. Methods We applied a large-scale cross-sectional research design using a survey. Data, generated using a questionnaire that was administered by companies specializing in providing online panels, were collected from random samples of baby boomers in the United Kingdom, the United States, and New Zealand. The total sample comprised 996 baby boomers born between 1946 and 1964, who had used the internet in the previous 6 months to search for and share health-related information. Data were analyzed using hierarchical cluster analysis and confirmatory factor analysis, as well as one-way analysis of variance, chi-square tests, and paired sample t tests. Results Analyses identified 3 key decision-making styles that served as the base for 4 unique and stable segments of patients with distinctive decision-making styles: the Collaborators (229/996, 23.0%), the Autonomous-Collaborators (385/996, 38.7%), the Assertive-Collaborators (111/996, 11.1%), and the Passives (271/996, 27.2%). Profiles were further developed for these segments according to key differences in the online health information behavior, demographics, and interactional behaviors of patients. The typology demonstrates that collaborative decision making is dominant among patients either in its pure form or in combination with autonomous or assertive decision making. In other words, most patients (725/996, 72.8%) show significant collaboration in their decision making with health care professionals. However, at times, patients in the combination Autonomous-Collaborative segment prefer to exercise individual autonomy in their decision making, and those in the combination Assertive-Collaborative segment prefer to be assertive with health professionals. Finally, this study shows that a substantial number of patients adopt a distinctly passive decision-making style (271/996, 27.2%). Conclusions The patient typology provides a framework for distinguishing practice-relevant and addressable segments with important implications for health care practitioners, including better-targeted communication programs for patients and more successful outcomes for health care services in the long term.

Consulting online health resources to co-create value: A typology of patient decision making styles

2018 ◽  
Vol 2018 (1) ◽  
pp. 13350
Author(s):  
Lynn Sudbury-Riley ◽  
Mary FitzPatrick ◽  
Alexandra Hess ◽  
Peter J Peter J Schulz
Keyword(s):  
Decision Making ◽  
Health Resources ◽  
Patient Decision Making ◽  
Patient Decision ◽  
Decision Making Styles

Does Societal Cost Information Affect Patient Decision-Making in Carpal Tunnel Syndrome? A Randomized Controlled Trial

Hand ◽  
2019 ◽  
pp. 155894471987339
Author(s):  
Joost T. P. Kortlever ◽  
Thompson Zhuang ◽  
David Ring ◽  
Lee M. Reichel ◽  
Gregg A. Vagner ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Costs ◽  
Controlled Trial ◽  
Societal Cost ◽  
Treatment Choice ◽  
Cost Information ◽  
Patient Decision Making ◽  
Patient Decision ◽  
Care Costs

Background: Despite studies demonstrating the effects of out-of-pocket costs on decision-making, the effect of societal cost information on patient decision-making is unknown. Given the considerable societal impact of cost of care for carpal tunnel syndrome (CTS), providing societal cost data to patients with CTS could affect decision-making and provide a strategy for reducing national health care costs. Therefore, we assessed the following hypotheses: (1) there is no difference in treatment choice (surgery vs no surgery) in a hypothetical case of mild CTS between patients randomized to receive societal cost information compared with those who did not receive this information; (2) there are no factors (eg, sex, experience with a previous diagnosis of CTS, or receiving societal cost information) independently associated with the choice for surgery; and (3) there is no difference in attitudes toward health care costs between patients choosing surgery and those who did not. Methods: In this randomized controlled trial using a hypothetical scenario, we prospectively enrolled 184 new and return patients with a nontraumatic upper extremity diagnosis. We recorded patient demographics, treatment choice in the hypothetical case of mild CTS, and their attitudes toward health care costs. Results: Treatment choice was not affected by receiving societal cost information. None of the demographic or illness factors assessed were independently associated with the choice for surgery. Patients declining surgery felt more strongly that doctors should consider their out-of-pocket costs when making recommendations. Conclusions: Providing societal cost information does not seem to affect decision-making and may not reduce the overall health care costs. For patients with CTS, health policy could nudge toward better resource utilization and finding the best care pathways for nonoperative and invasive treatments.

scholarly journals Barriers to Implementation of Perinatal Death Audit in Maternity and Pediatric Hospitals in Jordan: Cross-Sectional Study (Preprint)

2018 ◽  
Author(s):  
Yousef Khader ◽  
Mohammad Alyahya ◽  
Anwar Batieha
Keyword(s):  
Health Care ◽  
Health Information ◽  
Patient Information ◽  
Health Professionals ◽  
Perinatal Death ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hospital Records

BACKGROUND Perinatal death audit is a feasible and cost-effective quality improvement tool that helps to improve the quality of health care and reduce perinatal deaths. Perinatal death audit is not implemented in almost all hospitals in Jordan. OBJECTIVE This study aimed to assess health professionals’ attitude toward perinatal death auditing and determine the main barriers for effective implementation of perinatal death auditing as perceived by health professionals in Jordanian hospitals. METHODS A cross-sectional study was conducted among health professionals in 4 hospitals in Jordan. All physicians (pediatricians and obstetricians) and nurses working in these hospitals were invited to participate in the study. The study questionnaire assessed the attitude of health professionals toward perinatal death audit and assessed barriers for implementation of perinatal death audit in their hospitals. RESULTS This study included a total of 84 physicians and 218 nurses working in the 4 selected maternity hospitals. Only 35% (29/84) of physicians and 36.2% (79/218) of nurses reported that perinatal death audit would help to improve the quality of prenatal health care services to a great or very great extent. Lack of time was the first-mentioned barrier for implementing perinatal death audit by both physicians (35/84, 42%) and nurses (80/218, 36.7%). Almost the same proportions of health professionals reported inadequate patient information being documented in hospital records as a barrier. Lack of a health information system was the third-mentioned barrier by health professionals. Fear of having conflicts with the family of the dead baby was reported by almost one-third of physicians and nurses. Only 28% (23/83) of physicians and 16.9% (36/213) of nurses reported that they would like to be involved in perinatal death audit in their health facilities. CONCLUSIONS Health professionals in Jordan had poor attitude toward perinatal death audit. The main barriers for implementing perinatal death audit in Jordanian hospitals were lack of time, inadequate patient information being documented in hospital records, and lack of health information systems.

scholarly journals A Virtual Health Library for Dementia Patients and Caregivers to Improve Quality of Information and Communication

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 249-249
Author(s):  
Kirsten Mengell ◽  
Alyssa Indelicato ◽  
Sarah Lawler ◽  
Nancy Smith ◽  
Sharon Brangman ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Information ◽  
Patient Decision Making ◽  
Public Health Professionals ◽  
Dementia Patients ◽  
Patient Decision ◽  
Final Questionnaire ◽  
Quality Health ◽  
Information And Communication ◽  
Areas Of Interest

Abstract Access to accurate health information is critical for patient decision making and health communication. Unfortunately, there is limited quality health information for dementia patients and their caregivers. A Virtual Health Library (VHL) provided access to credible health information through the electronic medical record (EMR) to reach the dementia patients and their caregivers. A VHL was created and brought together clinicians, caregivers, technology support personnel, public health professionals, and the health sciences library. The team identified areas of interest and met monthly to create VHL materials. Materials included voice-over slides and 1-page educational content that was uploaded to the EMR for patient and caregiver access. A baseline and final questionnaire assessed demographics, empowerment, and shared decision making for both the patient and the caregivers and a pre/post was created for each module to asses knowledge and stratification. Initially, 1331 patients with dementia were recruited for the project from a university geriatrics department. The population had a 28.3% enrollment in the EMR and only 3.8% used the EMR in the past six months. Of this pool, during the initial launch 32 patients and or caregivers completed the baseline within the first week. 98% of respondents were caregivers with an average age of 58.7. With the youngest caregiver 42 and the oldest 88. Of the caregiver’s relationships to the patients is 43.3% their child, 40% their spouse, 10% other family, and 6.7% friends. During the project, participants improved access to health information and became empowered to engage with their healthcare provider.

scholarly journals Medical Help-Seeking Strategies for Perinatal Women With Obstetric and Mental Health Problems and Changes in Medical Decision Making Based on Online Health Information: Path Analysis (Preprint)

2019 ◽  
Author(s):  
Kyungmi Chung ◽  
Hee Young Cho ◽  
Young Ran Kim ◽  
Kyungun Jhung ◽  
Hwa Seon Koo ◽  
...  
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Problem Solving ◽  
Health Information ◽  
Mental Health Problem ◽  
Health Professionals ◽  
Help Seeking ◽  
Perinatal Period ◽  
Online Health Information ◽  
Perinatal Women

BACKGROUND Previous studies have revealed that most pregnant women rarely discuss informal information found on the internet with health professionals and have frequently expressed concerns for medical experts’ reactions to the online information they shared, as well as the lack of time to consult the medical experts in general. To date, little information is available on the effect of individual differences in utilizing medical help-seeking strategies on their medical decisions during the perinatal period. OBJECTIVE The objectives of this study were (1) to determine associations among perinatal women’s medical help-seeking strategies, changes in medical decision making, and online health information utilization with a focus on the mediating effect of self-efficacy in perinatal health literacy on the intent to consult health professionals, and (2) to clarify these associations in perinatal women with two different medical problems: obstetric and mental health. METHODS A total of 164 perinatal women aged 24 to 47 years (mean 34.64, SD 3.80) repeatedly completed the Problem Solving in Medicine and Online Health Information Utilization questionnaires to examine the moderating effect of two types of medical problems on their decision-making processes. To validate the hypothesized relationships in the proposed conceptual model encompassing obstetric and mental health problem-solving models, path analyses were performed. RESULTS This study found that some perinatal women, who use an online informal medical help-seeking (OIMH) strategy, would be more likely to change their medical decisions based only on internet-based information without consulting health professionals (<i>P</i>&lt;.001), compared to other women using different medical help-seeking strategies. Particularly, this concern is significantly prevalent when encountering obstetric problems during the perinatal period (obstetric problem-solving: <i>P</i>&lt;.001; mental health problem-solving: <i>P</i>=.02). Furthermore, perinatal women with mental health issues using the OIMH strategy showed a significant difference in intent to consult health professionals based on online health information when the medical problem they had to solve was different (obstetric problem-solving: <i>P</i>=.94; mental health problem-solving: <i>P</i>=.003). CONCLUSIONS Despite the positive mediating effects of perinatal women’s enhanced health literacy on the intent to discuss personal medical issues with health professionals based on online health information, the strategy used is of fundamental importance for understanding their help-seeking and decision-making processes during the perinatal period. Beyond a short consultation to steer patients quickly and authoritatively towards an obstetric doctor’s choice of action, it is recommended in this study that obstetricians attempt to provide their patients with needed context for the information found online. To fully explain this information with an open mind, they should actively develop or support information and communications technology (ICT)-based health information services.

scholarly journals Meeting the information needs of an evidence-based world

1999 ◽  
Vol 22 (2) ◽  
pp. 122 ◽  
Author(s):  
Beth Reid
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Information ◽  
Health Professionals ◽  
Information Needs ◽  
Information Age ◽  
Evidence Based ◽  
Individual Care ◽  
Evidence Based Decision Making ◽  
Support Evidence

There are many new and exciting health information developments in Australia today.However, there are also many gaps and problems in the information available to support evidence-based decision-making. For example, computerisation in health lags behind other industries. However, these problems should not prevent us using the available data to manage individual care and the health care system more effectively. It is fruitless to wait for atechnological solution to all our problems. Educational and staff changes are needed to prepare health professionals and patients to use information to make evidence-based decisions and bring health care into the information age.

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