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是改进这些过程的关键。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、图表列表、图表和图表、患者访谈。这些领域以前的工作强调了教育和族裔在理解和解释卫生信息方面的重要性。出于这个原因，这项研究将对四组参与者进行抽样，这些参与者按非裔美国人/白人种族以及受过大学教育和未受过大学教育水平的不同而不同。参与者：200名年龄在55-74岁之间的男性，他们因种族(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)而异。录像刺激材料：之前开发并测试了关于良性前列腺增生症(SDP/BPH)治疗决策的共享决策程序。该程序(附上3份供评审者审阅)已在以前的研究中进行了有效性和可理解性的测试，并通过几年的现场测试对图形设计进行了修改和改进。非洲裔美国人在接受采访的患者中扮演了录像带的叙述者的角色。这盘磁带代表了现有的最好的决策支持干预措施，使其成为调查患者对信息的解释对决策的影响的理想刺激材料。研究设计：本研究将采用结构化访谈的方法，以录像带为刺激。访谈将被录音，时长约为两个小时。内容分析将通过每隔一段时间实施的评级标准来加强。这项技术将使用一种不同的有声思考方案，定期停止磁带提问并管理简短的音量。调查前/调查后的仪器将通过电话管理。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)信息类型是否不同地影响参与者对信息重要性和显着性的理解？3)完整的信息给参与者带来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?