Talking About End-of-Life Preferences in Marriage: Applying the Theory of Motivated Information Management

Abstract

The theory of motivated information management (TMIM) provides one framework to examine information-seeking behaviors, especially in conversations involving sensitive or difficult information such as preferences for end-of-life (EOL) care. The spouse plays a significant role in decision making surrounding EOL care. Consequently, individuals need information about spouses' EOL preferences in order to ensure carrying out those desires. Our findings support the value of TMIM as a framework to understand factors that influence couples' EOL care information-seeking behaviors. In support of the theory, we provide factors that influence the initiation or avoidance of EOL conversations between spouses.

Themes Addressed by Couples With Advanced Cancer During a Communication Skills Training Intervention

“…Although initiating conversations about preparation for death can present with significant challenges, couples who do discuss end of life preferences report less fear and anxiety [21] and greater ability to implement desired care. [22]…”

Complex Considerations in Couples’ Financial Information Management: Extending the Theory of Motivated Information Management

“…Previous studies have taken a similar approach, collapsing items intended to tap diverse facets of the efficacy construct into a single index. Rafferty et al (2015) found that communication, target, and coping efficacy formed a second-order model, and therefore treated the variable as “a single entity, efficacy judgments” (p. 414). Similarly, W.…”

“…The TMIM explains individuals' decisions to seek or avoid information regarding personally significant issues (W. A. Afifi & Weiner, 2004), and has been used to explain information management relating to challenging, taboo, or sensitive matters such as sexual health (Dillow & Labelle, 2014), organ donation wishes (W. A. , family health histories (FHH; Hovick, 2014), and end-of-life preferences (Rafferty, Cramer, Priddis, & Allen, 2015). In constructing the theory, W. A.…”

“…Previous studies have taken a similar approach, collapsing items intended to tap diverse facets of the efficacy construct into a single index. Rafferty et al (2015) found that communication, target, and coping efficacy formed a second-order model, and therefore treated the variable as "a single entity, efficacy judgments" (p. 414). Similarly, W. A. , and W. A. have opted to use modified versions of the efficacy measures upon finding poor fit for a latent efficacy construct defined by (variously) three or four dimensions of efficacy.…”

“…Previous tests of the TMIM have asked participants to provide general assessments of whether information seeking was expected to produce positive or negative outcomes (e.g., W. A. Afifi et al, 2004; Hovick, 2014; Rafferty et al, 2015; Wong, 2014). Measuring OEs at this global level, however, may fail to capture potentially unique contributions of specific kinds of outcome assessments.…”