How best to obtain consent to thrombolysis

溶栓 子群分析 背景(考古学) 心理学 医学 框架(结构) 偏爱 临床心理学 社会心理学 统计 内科学 数学 荟萃分析 古生物学 结构工程 心肌梗塞 工程类 生物
作者
Jingjing Gong,Yan Zhang,Jun Feng,Weiwei Zhang,Weimin Yin,Xinhuai Wu,Yanhong Hou,Yonghua Huang,Hongyun Liu,Danmin Miao
出处
期刊:Neurology [Lippincott Williams & Wilkins]
卷期号:86 (11): 1045-1052 被引量:10
标识
DOI:10.1212/wnl.0000000000002434
摘要

Objective:

To investigate the factors that influence the preferences of patients and their proxies concerning thrombolytic therapy and to determine how best to convey information.

Methods:

A total of 613 participants were randomly assigned to a positively or negatively framed group. Each participant completed a series of surveys. We applied latent class analysis (LCA) to explore participants9 patterns of choices of thrombolysis and to classify the participants into different subgroups. Then we performed regression analyses to investigate predictors of classification of the participants into each subgroup and to establish a thrombolytic decision-making model.

Results:

LCA indicated an optimal 3-subgroup model comprising intermediate, favorable to thrombolysis, and aversion to thrombolysis subgroups. Multiple regression analysis revealed that 10 factors predicted assignment to the intermediate subgroup and 4 factors predicted assignment to the aversion to thrombolysis subgroup compared with the favorable to thrombolysis subgroup. The χ2 tests indicated that the information presentation format and the context of thrombolysis influenced participants9 choices of thrombolysis and revealed a framing effect in different subgroups.

Conclusions:

The preference for thrombolysis was influenced by the positive vs negative framing scenarios, the format of item presentation, the context of thrombolysis, and individual characteristics. Inconsistent results may be due to participant heterogeneity and the evaluation of limited factors in previous studies. Based on a decision model of thrombolysis, physicians should consider the effects of positive vs negative framing and should seek a neutral tone when presenting the facts, providing an important reference point for health persuasion in other clinical domains.
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