Differences in simulated doctor and patient medical decision making: a construal level perspective

Risk communication in cataract surgery

PURPOSE

Risk communication is an integral aspect of shared decision-making and evidence-based patient choice. There is currently no recommended way of communicating risks and benefits of cataract surgery to patients. This study aims to investigate whether the way this information is presented influences patients' perception of how risky surgery will be.

METHODS AND ANALYSIS

Two-arm parallel randomised study and patients referred for cataract surgery were assigned to receive information framed either positively (99% chance of no adverse effects) or negatively (1% chance of adverse effects). Subsequently, patients rated their perceived risk of experiencing surgical side effects on a 1-6 scale.

RESULTS

This study included 100 patients, 50 in each study group. Median (IQR) risk perception was 2 (1-2) in the positive framing group and 3 (1-3) in the negative framing group (p<0.0001). Risk framing was the only factor that was significant in risk perception, with no differences found by other patient clinical or demographic characteristics.

CONCLUSION

Patients who received positive framing reported lower risk scores for cataract surgery than patients who received negative framing. Patient factors were not identified as significant determinants in patients' perceived risk. Larger longitudinal studies are warranted to further investigate.

Choosing between the red and the blue pill. How do people decide when they face uncertainty regarding different treatment alternatives?

BACKGROUND

When we are faced with health challenges, we have to choose a treatment from several alternatives. Most of the time, we must make a choice even though some information regarding the options is missing. Previous research found that missing information systematically impacts our choices.

AIM

The present study investigated if context-related variables (type of information: advantages or costs, the label of the alternatives) and individual differences (moral purity, thinking style) have an impact on the way people make these kinds of choices. Methods: One hundred twenty-three students (52% males) had to make 27 decisions regarding their preferred alternative for treating various medical conditions. We manipulated the type of comparable information (i.e., regarding advantages, disadvantages, or costs), and the label of the treatment alternatives (i.e., abstract vs. recognizabletreatments). Additionally, we measured the participants' moral purity endorsement and thinking style via self-report questionnaires.

RESULTS

The results showed that context variables like the type of comparable information and the label of the alternatives are significant predictors of people's medical treatment choices. At the same time, self-reported measures were unrelated to the way people choose medical treatment.

CONCLUSION

The results highlight the importance of discussing the issue of missing information with healthcare consumers and patients.

Analyzing Relationship between Patient and Doctor in Public Dental Health using Particle Memetic Multivariable Logistic Regression Analysis Approach (MLRA2)

In the developing technology managing patient and doctor relationship and communication process is one of the critical factors because the patient may take high risk surgery, treatment and diagnosis. Due to the importance of the patient-doctor relationship, in this paper investigate the various aspects of relation between the doctor and dental problem related patients. During the analyzing process, data has been collected from adults who are facing dental problems and other dental injuries in which data has been gathered from 423 individuals by conducting interviews. The gathered data is investigated with the help of particle-memetic multivariable logistic regression analysis method which examines the patient income, dental surgical details, injuries and other factors relationship has been investigated. From the analyzed data, how the patients are treated by doctors examined for improving the relationship between patient and doctor in public dental health aspects.

Mixed Frames and Risky Decision-Making

By applying unitive vocabulary, "die" or "save," to respective frames of the Asian disease problem, Tversky and Kahneman were able to define framing effect. In this study, we preliminarily explored the effect of mixed frames, which are characterized by the use of different vocabulary in one frame. In study 1, we found that only the sure option description had significant effect on decision-making, while the effects of risky option descriptions were not significant, nor were interactions between descriptions. In study 2, the results suggested that after controlling the effects of the hedonic tone of the sure options, risky option description did not significantly predict decision-making. In study 3, we found that neither the sure-to-risky option presentation order nor presentation order within risky options had significant effect on decision-making. We thus concluded that sure option description can serve as the decision-making foundation (reference point) for decision-makers in mixed frames.

Framing Effect in the Trolley Problem and Footbridge Dilemma

The present study investigated the effect of dilemma type, framing, and number of saved lives on moral decision making. A total of 591 undergraduates, with a mean age of 20.56 (SD = 1.37) were randomly assigned to 12 groups on the basis of a grid of two dilemma types (the trolley problem or the footbridge dilemma) by three frames (positive, neutral, or negative frame) by two different numbers of workers (5 or 15 people). The main effects of dilemma type, frame, and number of saved workers were all significant. The interaction of dilemma type and number of saved workers and the interaction of the three independent factors were significant. Results indicated that moral judgment is affected by framing. Specifically, people were more inclined to utilitarianism in the positive or neutral frame and more inclined to intuitionism in the negative frame. Furthermore, this effect can be moderated by dilemma type and number of saved lives. Implications of our results are discussed.

Promote health or prevent disease? The effects of health-related advertising on eating behavior intention

The health medical costs of colorectal cancer are increasingly higher in Taiwan. The National Health Insurance Administration (NHI) and The Health Promotion Administration of the Ministry of Health and Welfare (MOHW) in Taiwan encourage individuals to adopt an earnest approach to healthy behavior through advocacy advertising. However, the number of colorectal cancer patients continues to increase annually. Our study explored the effects of health-related advertisements (ads) on healthy behavior intentions as influenced by regulatory focus theory (RFT) and construal level theory (CLT). We conducted an experiment with different public health advocacy ads. A 2 (regulatory focus: promotion vs. prevention) × 2 (temporal distance: one month vs. one year) × 2 (graphics-text ratio: more pictures and less text vs. fewer pictures and more text) three-factor experiment was adopted. The multiple analysis of variance (MANOVA) results revealed that ads with higher construal levels (i.e., more text) had greater effects with a promotion-oriented regulatory focus. However, no significant differences were found in either attitude toward the ads or behavior intention when the regulatory focus was prevention. In addition, according to the young testers and those who were psychologically distant from colorectal cancer, different temporal distances and different construal levels had no statistically significantly effects on attitudes toward advertising or on behavior intentions. The results revealed that viewers found the information easier to understand when the ads triggered the regulatory focuses of the viewers and applied an appropriate graphics-text ratio, which resulted in favorable health-related advertising effectiveness. Thus, we provide two suggestions regarding the use of health-related advertising for MOHW in the future.

Moral hypocrisy on the basis of construal level: to be a utilitarian personal decision maker or to be a moral advisor?

BACKGROUND

People encounter various moral issues that involve making decisions for others by giving advice.

OBJECTIVE

This study investigated the characteristics of providing suggestions for oneself versus providing suggestions for others in ethical decision-making and the differences between them based on Construal Level Theory (CLT).

METHODS

A total of 768 undergraduate students from three universities in China were randomly assigned to eight groups on the basis of a grid of two Construal Levels (self or others) by two different numbers of people saved (5 people or 15 people) by two problem situations (trolley problem vs. footbridge problem). The investigation examined participants' decisions to opt to take action or refrain from action that would have the consequence of saving more people.

RESULTS

The main effects of Construal Level (F1, 752 = 6.46, p = .011), saving number (F1, 752 = 35.81, p < .001), and problem situation type (F1, 752 = 330.55, p < .001) were all significant. The interaction of the problem situation and saving number (F1, 752 = 1.01, p = .31), and social distance and saving number (F1, 752 = 0.85, p = .36), and interaction of the three independent factors (F1, 752 = 0.47, p = .49) were not significant. However, the interaction of social distance and problem situation (F1, 752 = 9.46, p = .002) was significant. Results indicated the participants utilized a component of utilitarian reasoning in the decision-making, and their behaviors appeared more utilitarian at low Construal Levels (CLs) compared to high.

CONCLUSION

CLs, saving numbers, and problem situation significantly affected moral decision-making and exhibited significant interaction. Making decisions for oneself (low-construal) rather than giving advice to others (high-construal) was one important factor that determined whether the people were utilitarian or not. Utilitarian considerations are more relevant in impersonal dilemmas.

Core self-evaluations mediate the associations of dispositional optimism and life satisfaction

Background

Positive traits, such as life satisfaction, optimism, and core self-evaluation (CSE), have garnered increasing attention from researchers and professionals. However, the trilateral relationship among them remains unclear.

Objective

This study examines the effect of dispositional optimism on life satisfaction and primarily verified the mediator role of CSEs.

Methods

Six hundred thirty college students from two general universities completed a questionnaire packet containing life orientation test–revised (LOT–R), core self-evaluations, and satisfaction with life scale. Confirmatory factor analysis (CFA) was conducted to assess the dimension of LOT–R. Bootstrap was used in structural equation modeling to analyze mediation effect.

Results

Results revealed that dispositional optimism and core self-evaluations were significantly correlated with life satisfaction. CFA identified the bidimensional structure of dispositional optimism. SEM indicated that core self-evaluations partially mediated the effect of dispositional optimism on life satisfaction. The final model also revealed significant paths from optimism and pessimism to life satisfaction through core-self evaluations.

Conclusion

The findings extended prior studies and shed light on how dispositional optimism influences life satisfaction. This study provides valuable evidence on how to promote the life satisfaction of human beings in positive psychology. A further study can fully explore the relationship among them in multi-cultural follow-up studies.