Clinical implications of numeracy: theory and practice.

Clinical implications of numeracy: theory and practice.
复制标题

算术的临床意义:理论和实践。

DOI:
10.1007/s12160-008-9037-8
复制
发表时间:
2008-06
影响因子:
3.8
通讯作者:
Peters, Ellen
Peters, Ellen
中科院分区:
心理学2区
文献类型:
--
作者:
Nelson, Wendy;Reyna, Valerie F.;Fagerlin, Angela;Lipkus, Isaac;Peters, Ellen

文献摘要

参考文献

被引文献

相似文献

低计算能力普遍存在,限制了患者的知情选择,降低了药物依从性,限制了获得治疗的机会,损害了风险沟通,并影响了医疗结果;因此,提供者有责任尽量减少其不利影响。我们提供对健康计算的研究概述,并讨论其在临床环境中的影响。不能根据患者的教育、智力或其他可观察到的特征可靠地推断出低计算能力。对计算能力的客观和主观评估以简短的形式提供,可用于量身定制卫生交流。在这些评估中得分较低的人受到认知偏差、不相关线索(如情绪)和更明显的时间折扣的影响。由于预防主要死亡原因(例如癌症和心血管疾病)取决于现在采取行动,以防止以后的严重后果,因此那些计算能力差的人可能需要更多地解释参与预防行为的风险。视觉显示可以使数字关系更加透明,不同类型的显示具有不同的效果(例如,更大的风险规避)。具有讽刺意味的是,优秀的定量处理似乎是通过关注定性依据和情感意义来实现的,这对于在循证医学中赋予患者利用证据的能力具有重要意义。
Low numeracy is pervasive and constrains informed patient choice, reduces medication compliance, limits access to treatments, impairs risk communication, and affects medical outcomes; therefore, it is incumbent upon providers to minimize its adverse effects. We provide an overview of research on health numeracy and discuss its implications in clinical contexts. Low numeracy cannot be reliably inferred on the basis of patients’ education, intelligence, or other observable characteristics. Objective and subjective assessments of numeracy are available in short forms and could be used to tailor health communication. Low scorers on these assessments are subject to cognitive biases, irrelevant cues (e.g., mood), and sharper temporal discounting. Because prevention of the leading causes of death (e.g., cancer and cardiovascular disease) depends on taking action now to prevent serious consequences later, those low in numeracy are likely to require more explanation of risk to engage in prevention behaviors. Visual displays can be used to make numerical relations more transparent, and different types of displays have different effects (e.g., greater risk avoidance). Ironically, superior quantitative processing seems to be achieved by focusing on qualitative gist and affective meaning, which has important implications for empowering patients to take advantage of the evidence in evidence-based medicine.
DOI: 10.1016/0749-5978(88)90036-2
发表时间: 1988-06-01
影响因子: 4.6
作者:
BRUN, W;TEIGEN, KH
通讯作者: TEIGEN, KH
DOI: 10.1200/jco.2003.06.025
发表时间: 2003-12-01
影响因子: 45.3
作者:
Chao, C;Studts, JL;McMasters, KM
通讯作者: McMasters, KM
DOI: 10.1097/00001888-200210000-00021
发表时间: 2002-10-01
期刊: ACADEMIC MEDICINE
影响因子: 7.4
作者:
Bass, PF;Wilson, JF;Barnett, DR
通讯作者: Barnett, DR
DOI: 10.2307/2288400
发表时间: 1984-01-01
影响因子: 3.7
作者:
CLEVELAND, WS;MCGILL, R
通讯作者: MCGILL, R
DOI: 10.1046/j.1525-1497.1998.00242.x
发表时间: 1998-12-01
影响因子: 5.7
作者:
Baker, DW;Parker, RM;Clark, WS
通讯作者: Clark, WS