Summary
Objective: This article describes the process undertaken to identify and validate behavioral
and normative beliefs and behavioral intent based on the Theory of Reasoned Action
(TRA) and applied to men between the ages of 45 and 70 in the context of their participation
in shared decision-making (SDM) in medically uncertain situations. This article also
discusses the preliminary results of the aforementioned processes and explores potential
future uses of this information that may facilitate greater understanding, efficiency
and effectiveness of clinician-patient consultations.
Materials and Methods: Twenty-five male subjects from the Philadelphia community participated in this study.
Individual semi-structure patient interviews were conducted until data saturation
was reached. Based on their review of the patient interview transcripts, researchers
conducted a qualitative content analysis to identify prevalent themes and, subsequently,
create a category framework. Qualitative indicators were used to evaluate respondents’
experiences, beliefs, and behavioral intent relative to participation in shared decision-making
during medical uncertainty.
Results: Based on the themes uncovered through the content analysis, a category framework
was developed to facilitate understanding and increase the accuracy of predictions
related to an individual’s behavioral intent to participate in shared decision-making
in medical uncertainty. The emerged themes included past experience with medical uncertainty,
individual personality, and the relationship between the patient and his physician.
The resulting three main framework categories include 1) an individual’s Foundation
for the concept of medical uncertainty, 2) how the individual Copes with medical uncertainty,
and 3) the individual’s Behavioral Intent to seek information and participate in shared
decision-making during times of medically uncertain situations.
Discussion: The theme of Coping (with uncertainty) emerged as a particularly critical behavior/characteristic
amongst the subjects. By understanding a subject’s disposition with regard to coping,
researchers were better able to make connections between a subject’s prior experiences,
their knowledge seeking activities, and their intent to participate in SDM. Despite
having information and social support, the subjects still had to cope with the idea
of uncertainty before determining how to proceed with regard to shared decision-making.
In addition, the coping category reinforced the importance of information seeking
behaviors and preferences for shared decision-making.
Conclusions: This study applies and extends the field of behavioral and health informatics to
assist medical practice and decision-making in situations of medical uncertainty.
More specifically, this study led to the development of a category framework that
facilitates the identification of an individual’s needs and motivational factors with
regard to their intent to participate in shared decision-making in situations of medical
uncertainty.
Keywords
Medical uncertainty - behavioral intent - shared decision-making
