INFORMATION INTERPRETATION IN PATIENT DECISION SUPPORT

知情患者决策是患者决策支持干预（DSI）和知情同意的中心目标。患者在做出知情决定时如何解释和使用信息对改善这些过程至关重要。我们建议检查通常用于向患者传达医疗风险和益处的信息类型：统计信息、图形列表、图形绘图和图表、患者访谈。先前在这些领域的工作强调教育和种族对理解和解释健康信息的重要性。因此，这项研究将根据非裔美国人/高加索人种、受过大学教育和没有受过大学教育的程度，对四组参与者进行抽样。参与者：200名年龄在55- 74岁之间的男性，根据种族（非裔美国人/高加索人）和教育程度（大学学历/非大学学历）而不同。录像刺激材料：先前开发并测试了用于良性前列腺增生（SDP/BPH）治疗决策的共享决策程序。该程序（附3份供审稿人使用）已在先前的研究中进行了有效性和可理解性测试，并经过数年的实地测试，在平面设计上进行了修改和改进。非裔美国人是磁带的叙述者，也是接受采访的病人之一。磁带代表了最佳的决策支持干预措施，使其成为理想的刺激材料，以调查患者对信息的解释对决策的影响。研究设计：本研究将采用结构化访谈法，以录像带作为刺激。采访将用录音带录制，时长约为两小时。内容分析将通过每隔一段时间进行评级来增强。这项技术将使用一种“有声思考”协议的变体，周期性地停止录音，提出问题，并进行简短的评分。前/后调查工具将通过电话管理。要解决的研究问题是：1)信息类型对参与者选择治疗的可能性有不同的影响吗？2)信息类型是否会影响参与者对信息重要性和显著性的理解？3)完整的信息给参与者提出了哪些新的问题或担忧？

Informed patient decision-making is the central goal of patient decision support intervention (DSI) and informed consent. How patients interpret and use information in reaching informed decisions is critical to improving these processes. We propose to examine information types commonly used to communicate risks and benefits of medical treatments to patients: statistical information, graphical lists, graphical drawings and diagrams, patient interviews. Prior work in these fields emphasizes the importance of education and ethnicity on comprehension and interpretation of health information. For that reason, this study will sample four groups of participants varied by African American/Caucasian ethnicity and college-educated and not college-educated education levels. Participants: 200 men age 55- 74, varied by ethnicity (African American/Caucasian) and education (college-educated/not college educated). Videotaped Stimulus Material: Previously developed and tested Shared Decision-making Program for treatment decisions about benign prostatic hyperplasia (SDP/BPH). The program (3 copies enclosed for reviewers) has been tested in previous studies for efficacy and comprehensibility and revised and improved in graphic design by several years of field-testing. African Americans figure as the narrator of the tape and among patients interviewed. The tape represents the best available decision support interventions, making it ideal stimulus material to investigate patients' interpretation of information the impact on decisions. Study Design: The study will employ a structured interview approach, with the videotape as stimulus. Interviews will be audiotape recorded and will be approximately two hours in length. Content analysis will be augmented by rating scales administered at intervals. The technique will use a variation of think-aloud protocols, stopping the tape periodically to ask questions and administer brief scales. Pre/post survey instruments will be administered by telephone. Research questions to be addressed are: 1) Do information types differentially affect participants' likelihood to choose a treatment? 2) Do information types differentially affect participants' interpretation of importance and salience of the information? 3) What new questions or concerns are raised for participants by full information?