INFORMATION INTERPRETATION IN PATIENT DECISION SUPPORT

患者知情决策是患者决策支持干预（DSI）和知情同意的核心目标。 患者如何解释和使用信息来做出明智的决定对于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，图形图纸和图表，患者访谈。 在这些领域的先前工作强调教育和种族对理解和解释健康信息的重要性。 出于这个原因，本研究将对四组受试者进行抽样，这些受试者因非洲裔美国人/高加索人种族和大学教育程度而异。 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（受过大学教育/未受过大学教育）而有所不同。 录像刺激材料：之前开发并测试的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（3份副本附在审查员）已在以前的研究中进行了有效性和可理解性的测试，并通过几年的实地测试在图形设计中进行了修订和改进。 非洲裔美国人是录像带的叙述者，也是接受采访的病人之一。 磁带代表了最好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：本研究采用结构化访谈法，以录像带为刺激材料。 访谈将录音，时长约两小时。内容分析将通过定期管理的评级量表来加强。 该技术将使用一种有声思维协议的变体，定期停止录音以提出问题并管理简短的量表。 将通过电话管理调查前/调查后工具。 需要解决的研究问题是：1）信息类型是否不同地影响参与者选择治疗的可能性？2)信息类型是否会对被试对信息的重要性和显著性的理解产生不同的影响？3)充分信息会给与会者提出哪些新的问题或关切？

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?