BACKGROUND:Decision aids (DAs) are non-directive communication tools that help patients make value-consistent health-care decisions. However, most DAs have been developed without an explicit theoretical framework, resulting in a lack of understanding of how DAs achieve outcomes. OBJECTIVE: To investigate the effect of promoting affective vs. deliberative processing on DA effectiveness based on dual-process theory. DESIGN, SETTING AND PARTICIPANTS: One hundred and forty-eight female university students participated in a randomized controlled experiment with three conditions: emotion-focused, information-focused and control. Preference-value consistency, knowledge, decisional conflict and satisfaction were compared across the conditions using planned contrast analyses. INTERVENTION: The intervention comprised two different DAs and instructional manipulations. The emotion-focused condition received a modified DA with affective content and instructions to induce an affective reaction. The information-focused and control conditions received the same DA without the affective content. The information-focused condition received additional instructions to induce deliberative processing. RESULTS: Controlling for the experiment-wise error rate at P < 0.017, the emotion-focused and information-focused conditions had significantly higher decisional satisfaction than the control condition (P < 0.001). The emotion-focused condition did not demonstrate preference-value consistency. There were no significant differences for decisional conflict and knowledge. DISCUSSION: Results suggest that the promotion of affective processing may hinder value-consistent decision making, while deliberative processing may enhance decisional satisfaction. CONCLUSIONS: This investigation of the effect of affective and deliberative processes in DA-supported decision making has implications for the design and use of DAs. DA effectiveness may be enhanced by incorporating a simple instruction to focus on the details of the information.
RCT Entities:
BACKGROUND: Decision aids (DAs) are non-directive communication tools that help patients make value-consistent health-care decisions. However, most DAs have been developed without an explicit theoretical framework, resulting in a lack of understanding of how DAs achieve outcomes. OBJECTIVE: To investigate the effect of promoting affective vs. deliberative processing on DA effectiveness based on dual-process theory. DESIGN, SETTING AND PARTICIPANTS: One hundred and forty-eight female university students participated in a randomized controlled experiment with three conditions: emotion-focused, information-focused and control. Preference-value consistency, knowledge, decisional conflict and satisfaction were compared across the conditions using planned contrast analyses. INTERVENTION: The intervention comprised two different DAs and instructional manipulations. The emotion-focused condition received a modified DA with affective content and instructions to induce an affective reaction. The information-focused and control conditions received the same DA without the affective content. The information-focused condition received additional instructions to induce deliberative processing. RESULTS: Controlling for the experiment-wise error rate at P < 0.017, the emotion-focused and information-focused conditions had significantly higher decisional satisfaction than the control condition (P < 0.001). The emotion-focused condition did not demonstrate preference-value consistency. There were no significant differences for decisional conflict and knowledge. DISCUSSION: Results suggest that the promotion of affective processing may hinder value-consistent decision making, while deliberative processing may enhance decisional satisfaction. CONCLUSIONS: This investigation of the effect of affective and deliberative processes in DA-supported decision making has implications for the design and use of DAs. DA effectiveness may be enhanced by incorporating a simple instruction to focus on the details of the information.
Authors: Marc D Schwartz; Beth N Peshkin; Kenneth P Tercyak; Kathryn L Taylor; Heiddis Valdimarsdottir Journal: Health Psychol Date: 2005-07 Impact factor: 4.267
Authors: M Holmes-Rovner; J Kroll; N Schmitt; D R Rovner; M L Breer; M L Rothert; G Padonu; G Talarczyk Journal: Med Decis Making Date: 1996 Jan-Mar Impact factor: 2.583
Authors: A M O'Connor; P Tugwell; G A Wells; T Elmslie; E Jolly; G Hollingworth; R McPherson; H Bunn; I Graham; E Drake Journal: Patient Educ Couns Date: 1998-03