A psychological study of the inverse relationship between perceived risk and perceived benefit

Judgments of risk and judgments of benefit have been found to be inversely related. Activities or technologies that are judged high in risk tend to be judged low in benefit, and vice versa. In the present study, we examine this inverse relationship in detail, using two measures of relationship between risk and benefit. We find that the inverse relationship is robust and indicative of a confounding of risk and benefit in people's minds. This confounding is linked to a person's overall evaluation of an activity or technology. Theoretical and practical implications of this risk-benefit confounding are discussed.

QALYs, HYEs and individual preferences--a graphical illustration

The choice of outcome measure in cost-utility analysis has been a matter of concern. In particular the theoretical properties of quality-adjusted life-years (QALYs) and healthy-years equivalents (HYEs) have been debated. In this paper the underlying preference assumptions of QALYs and HYEs are illustrated graphically. For QALYs the assumptions of mutual utility independence, constant proportional trade-off, and risk neutrality are explained and illustrated. Mutual utility independence is shown to guarantee that the quality weight with the standard gamble method is independent of the number of years in the health state and constant proportional trade-off is shown to guarantee that the quality weight with the time-trade-off method is independent of the number of years in the health state. Together these two assumptions leads to a utility function over life-years that exhibits constant proportional risk posture, which is the basis for the risk-adjusted QALY model. The more commonly used risk-neutral QALY model is shown to be a valid cardinal utility function if risk neutrality over life-years holds for all health states. For HYEs to be a valid cardinal utility function the somewhat less restrictive assumption of risk neutrality over life-years in full health has to be made. It is also shown graphically that the proposed two-stage procedure to measure HYEs in theory gives the same result as directly using the time-trade-off method. Finally, it is shown that by estimating the certainty-equivalent number of HYEs it is possible in theory to obtain a measure that will always rank risky health profiles according to individual preferences. It is concluded that further empirical work should be undertaken to test the ranking properties of the different measures.

The effect of primary nursing job design dimensions on caregiving technology and job performance in nursing homes

Primary nursing job design, ie permanent assignment and increased job autonomy and communication, has been suggested as especially appropriate for long-term care. The present study examined its effects on nursing home assistants' (N = 248) job performance and technology perceptions. Job design was found to have a significant effect on caregiving technology, even after controlling for individual differences. In particular, increased autonomy was significantly related to increased task variability which suggests that nursing assistants who have more job autonomy provide more customized care. Unexpectedly, increased duration of assignment was significantly related to increased homogeneity of tasks. Suggestions for future job design research in long-term care are made.

Towards a perspective theory of decision making and judgment

The notion of perspectives in its literal perceptual sense is assumed to shed light on thinking in general and evaluative processes in decision making and judgments in particular. Three determinants of perspectives in thinking are identified: (a) the subject, i.e., subject orientation, (b) the object, and (c) psychological distance between subject and object. Dependent on the congruence between subject orientation and characteristics of the object different figure-ground relationships are formed. When an inside perspective is adopted (the object is seen as affiliated with the subject) positive features form the ground and negative features are in the background. Conversely, when an outside perspective is adopted (the object is seen as separate from the subject) negative features form the figure and positive features are in the background. A model is outlined for relationships among perspectives, evaluations and external constraints in decision making and judgment. Empirical data from three empirical studies illustrate the validity of the framework described in the paper.

Enhancing multi-agency collaboration in the management of child sexual abuse

Conflict naturally occurs when multiple organizations with different mandates interact to deliver services to children who have been sexually abused. In this article, the authors review the underlying sources of conflict that impair interorganization functioning, and dysfunctional techniques used to manage such conflict. As an alternative to dysfunctional conflict management strategies, the authors develop a model for managing conflict which builds on concepts from the operations and negotiations literature. The approach the authors advocate involves the three steps of problem characterization, acknowledgement of relevant goals and interests, and negotiation when interests are in conflict. The benefit of this approach, and difficulties encountered when employing it, are discussed.

Public perceptions of the potential hazards associated with food production and food consumption: an empirical study

Although public perceptions of food-related hazards receive much media comment and debate, the research literature on such perceptions is sparse and piecemeal. In the reported study, 216 people completed a questionnaire relating to their perceptions of the "risk characteristics" of potential hazards associated with various aspects of food production and food consumption. Responses were examined via principal-components analysis to obtain a structural representation of risk perception of the kind provided by Fischhoff, Slovic, and their colleagues in their seminal psychometric work. A three-component solution accounting for 87% of the variance was obtained, with the dimensions labeled as "severity," "unknown," and "number of people exposed." The findings also yielded information pointing to evidence of the phenomenon of unrealistic optimism. We conclude that our findings offer a useful base upon which further in-depth research integrating different perspectives on risk perception with respect to food-related hazards may be developed.

Factors affecting the intention-physical activity relationship: intention versus expectation and scale correspondence

The present study examined two issues believed to be relevant for the application of the theory of planned behavior to the physical activity domain: (a) the conceptual distinction between intention and expectation and (b) the effect of failing to obtain scale correspondence (Courneya & McAuley, 1993). Subjects for the study were 170 undergraduate students who completed an initial questionnaire assessing the constructs of interest and follow-up self-reports of physical activity at 2 and 4 weeks. Results indicated that: (a) expectation shared 9% more variance with frequency of physical activity than did intention, and (b) scale correspondence significantly improved the correlation between intention and physical activity. Discussion focused on conceptual and methodological issues concerning the theory of planned behavior as applied to physical activity.

Self-Efficacy and Performance as a Function of Feedback Sign and Anxiety: A Service Experiment

Self-efficacy has become a central explanatory variable in work behavior, yet little is known about how it is formed and how it changes. Rather than being the simple direct effects model, which is widely accepted, it is proposed that trait anxiety and feedback sign interact to affect self-efficacy. It is also proposed that, due to selection effects, trait anxiety exists as a vulnerability of self-efficacy in situations with low barriers to exit, rather than as an interacting variable. The results of a quasi-experimental field study supported both propositions.

Confidence in own and others' knowledge

A person's confidence judgement of a statement reflects his/her degree of belief in the correctness of that statement. Deficient ability to assess the correctness of statements (or beliefs) can have serious consequences in many situations. This study compares the realism (calibration) of subjects' confidence ratings in two situations (n = 64). The first situation was when the subjects confidence rated their own answers to general knowledge questions. The second was when the subjects gave confidence ratings of another person's answers to general knowledge questions. The results show that subjects were more poorly calibrated and were more overconfident in the second situation, i.e. when they gave confidence ratings of answers given by another person, compared with when they rated their own answers. The data further indicates that the results can not be explained in terms of the amount of cognitive processes invested when making the confidence judgements. For example, the subjects rated the other person's answers to questions they had answered themselves, and to questions they had not seen before. No differences in confidence or in calibration and other measures of judgmental realism were found between these two categories of questions. Nor did instructions to imagine the thought process of the other person improve any of these measures. The subjects disagreed with the other person's answer on 23% of all occasions. Significantly poorer calibration was shown where subjects disagreed with the other person than where they agreed. Contents of a social nature attended to by the subjects may have affected the results. The results, when related to previous research in the area, give rise to the question of how the social situation can be arranged to achieve the best calibration.

Adolescent sexual offenders: potential for a healthier lifestyle

Sexual victimization by adolescents is a serious problem of growing societal concern. As a result of such sexual offenses, family functioning and adolescent development may be compromised. Advanced practice psychiatric/mental health nurses can promote a healthier lifestyle for adolescent sexual offenders through assessment, early identification, and intervention to address the specific needs of the adolescents and their families and reduce the risk of sexual reoffense. The purpose of this paper is to explore the issues related to adolescent sexual offenders and their families, provide nurses with the knowledge to promote a healthier lifestyle for this population, and discuss implications for nursing practice, education, and research.

A pattern recognition account of decision making

In the domain of pattern recognition, experiments have shown that perceivers integrate multiple sources of information in an optimal manner. In contrast, other research has been interpreted to mean that decision making is nonoptimal. As an example, Tversky and Kahneman (1983) have shown that subjects commit a conjunction fallacy because they judge it more likely that a fictitious person named Linda is a bank teller and a feminist than just a bank teller. This judgment supposedly violates probability theory, because the probability of two events can never be greater than the probability of either event alone. The present research tests the hypothesis that subjects interpret this judgment task as a pattern recognition task. If this hypothesis is correct, subjects' judgments should be described accurately by the fuzzy logical model of perception (FLMP)--a successful model of pattern recognition. In the first experiment, the Linda task was extended to an expanded factorial design with five vocations and five avocations. The probability ratings were described well by the FLMP and described poorly by a simple probability model. The second experiment included (1) two fictitious people, Linda and Joan, as response alternatives and (2) both ratings and categorization judgments. Although the ratings were accurately described by both the FLMP and an averaging of the sources of information, the categorization judgments were described better by the FLMP. These results reveal important similarities in recognizing patterns and in decision making. Given that the FLMP is an optimal method for combining multiple sources of information, the probability judgments appear to be optimal in the same manner as pattern-recognition judgments.

Contributors to satisfaction with management in hospital wards

The purpose of this study was to identify management-related factors contributing to personnel satisfaction in hospital wards. The sample population consisted of the employees of 15 hospital wards in four medical departments. The wards were classified into two categories on the basis of the satisfaction of the personnel with the management: 'satisfied wards' (seven wards with a highly satisfied personnel, n = 124) and 'other wards' (eight wards, n = 186). The employees of 'satisfied wards' reported more innovative activities and continuous quality improvements, more possibilities to participate in decision-making, more efficient communication within the ward and between other units, and more managerial activities for promoting the well-being of the staff compared with the personnel of 'other wards'. According to the ratings of the nursing directors, the quality of patient care in the 'satisfied wards' was higher, but there were no differences in cost-effectiveness between the study groups.

Time pressure and the application of decision rules: choices and judgments among multiattribute alternatives

The effects of time pressure on decisions and judgments were studied and related to the use of different decision rules in a multiattribute decision task. The decision alternatives were students described by their high school grades in Swedish, Psychology and Natural Science. The subjects were asked to choose the student they thought would be most able to follow a university program and graduate as a school psychologist. On the basis of earlier findings using the same kind of decision task (Svenson et al., 1990) it was hypothesised that subjects under time pressure would prefer candidates having the maximum grade across all attributes to a greater extent than subjects under no time pressure. Furthermore, it was hypothesised that subjects under time pressure would also focus more on the most important attribute and choose the alternatives being best on that attribute. The results supported these hypotheses.