Patient decision‐making modes and causes: A preliminary investigation

Abstract

A recent study of patient decision making regarding acceptance of an implantable cardiac defibrillator (ICD) provides a substantial but nonrandom sample (N = 191) of telephone interviews with persons who have made an affirmative decision regarding an ICD. Using a coding scheme developed through qualitative analysis of transcribed interviews, these data can be subjected to exploratory statistical analysis. The reasons given by respondents for getting the ICD differed by both region and gender, and show some correlations with whether the device has or has not delivered any stimulation (shocks) since implantation. Cluster analysis reveals association among certain important themes in the discussion of the decision process, particularly linking rather opposite concepts into clusters related to specific dimensions. The results suggest the importance, to patients, of maintaining the integrity of the self by asserting control and independence. The majority of the respondents (61%) have not received the primary intended benefit of the device (stimulation). Thus, the findings suggest that psychological benefits alone of having the device (such as anxiety reduction) serve to justify acceptance of a computerized device. Implications for other lines of computerized health support and for further study of these issues are discussed.

Embodying a New Meaning of Being At Risk

“…Central to this process of adjusting and accepting was finding ways to manage the ICD, while moving forward with activities of everyday life. Similar to findings in other studies (Kantor, Bullinger, & Gal, 2012;Morken et al, 2010;Zeigler & Nelms, 2009), the ICD was described as providing participants with a newfound sense of safety that did not exist prior to its implantation. The ICD shifted from being something that symbolized an increase in at-risk status to a technology that prevented them from being at risk.…”

Patient portal preferences: Perspectives on imaging information

“…This demonstrates the need to develop tools that provide patients with health information that is easy to access and that is recognizably of quality. Despite the increases in patients accessing health information online, little research has been done to demonstrate why consumers trust specific digital sources (Kantor, Bullinger, & Gal, 2012), and patients still cite the need to determine the quality of a source (McKemmish et al, 2009). Perceived ease of access and quality are factors affecting use rates of healthcare technological tools (Rogers, 1995;Silvestre, Sue, & Allen, 2009).…”

Adult patient decision-making regarding implantation of complex cardiac devices: a scoping review

“…Gender: despite little mention of potential gender differences, one study found that women were 2.7 times more likely than men to actively confirm their ICD decision to others and consider the physician to be a detailed information giver rather than authority figure. 55,66 Passivity was influenced by the degree of importance assigned to various situational factors:…”