Environmental stress and individual decision-making: Implications for the patient

Schaeffer, Monica H.

doi:10.1016/0738-3991(89)90018-9

Cited by 19 publications

(20 citation statements)

References 28 publications

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“…Johnson 1939). The observation of impaired implicit risk assessment is consistent with Schaeffer (1989) reporting that stress-related effects on decision making include an increase in the use of heuristics and also with Keinan (1987) who reports screening of alternatives to happen in a more hazardous fashion when subjects are stressed. The observed confidence-related stress effects match previous results reported in the literature only in part.…”

Section: Discussionsupporting

confidence: 85%

“…The observed confidence-related stress effects match previous results reported in the literature only in part. Like Schaeffer (1989) we observed an increase in decision confidence in stressed subjects, but only in trials associated with either high or low stimulus uncertainty and just when the task included residual uncertainty (20%, Exp.1). In addition, when outcome probabilities were known stress even led to decreased confidence (Exp.2).…”

Section: Discussionmentioning

confidence: 60%

“…, Festinger 1943;Garrett 1922;Johnson 1939). However, apart from Schaeffer's (1989) work the influence of stress on decision confidence as compared to a straight control condition seems to lack investigation. Schaeffer (1989) reports that stress induced by annoying context sound leads to increased confidence in the decisions that are made.…”

Section: Introductionmentioning

confidence: 90%

“…Schaeffer (1989) reports that stress induced by annoying context sound leads to increased confidence in the decisions that are made. In short, excessive cognitive demands tend to elicit a stress response which includes heightened arousal (Schaeffer 1989) and high arousal can increase risk-seeking (Fessler et al 2004;Leith and Baumeister 1996;Mano 1994).…”

Section: Introductionmentioning

confidence: 97%

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Stress, Uncertainty and Decision Confidence

Heereman

Walla

2011

Appl Psychophysiol Biofeedback

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We successfully manipulated decision confidence in a probabilistic prediction task by means of stress as induced by excessive cognitive demands. In particular, our results indicate that decisions (based on high and low, but not intermediate levels of uncertainty) made under stress (confirmed by skin conductance measures) are associated with increased confidence when outcome probabilities are incompletely known (20% residual uncertainty). A different pattern was found when outcome probabilities were completely known (0% residual uncertainty). Here, stress led to decreased decision confidence when decisions were associated with intermediate levels of uncertainty but had no effect in case of high and low levels of uncertainty. In addition we provide evidence for ambiguity--(understood as implicit-risk) assessment being impaired under stress conditions.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 60%

Section: Introductionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 97%

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Stress, Uncertainty and Decision Confidence

Heereman

Walla

2011

Appl Psychophysiol Biofeedback

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“…In hospital the perception was that it was a quicker, more urgent decision. Many factors may be involved in this situation: difficulty with processing new information at a time of stress [23], paternalistic approach of medical teams in the acute setting, genuinely urgent medical need, a shift in a patient's health locus as an inpatient in hospital compared to being in his/her own home [24]. Greater care is needed to ensure effective communication under difficult circumstances.…”

Section: Principal Findingsmentioning

confidence: 99%

A Pilot Study Exploring the Factors that Influence the Decision to have PEG Feeding in Patients with Progressive Conditions

2008

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This original pilot study was conducted to explore and understand the factors that influence a patient's decision-making when considering percutaneous endoscopic gastrostomy placement for nonoral nutrition and hydration supplementation. Seven patients living with progressive dysphagic symptoms who had made a decision about percutaneous endoscopic gastrostomy placement were interviewed and their responses analyzed using the constant comparison method. All participants felt they had no option other than to accept the percutaneous endoscopic gastrostomy. The impact of visible physical deterioration and medical opinion were the most powerful influences on patients' decisions. Patients' perception of their involvement in the decision varied. This was linked to the amount and timing of information supplied and support they felt they received. Few patients have prior knowledge of tube feeding and rely heavily on medical advice. Effective communication by healthcare professionals can promote an environment that is supportive of patients' involvement in decisions. Adequate preparation time is vital if patients are to stop feeling uninvolved or peripheral to the decision-making process. Multidisciplinary teams need to address their working practices so that they do not intimidate patients, but rather empower patients in their decision-making.

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