The Research On The Role Of Different Framings And Resilience In Medical Risk Decision-making Behavior

Risky decision-making is the complex psychological process produced by thedecision makers when they make a decision between two or more inconclusive results.As the core concept of the important “prospect theory”, the “framing effect” pointed outthat people may show the preference change on the same decision due to the semanticchange. Generally, medical information is presented in the form of “survival” or “death”.It may affect one’s decision when the same information is described in the form ofpositive (survival) or negative (death), which can result in decision bias. This decisionbias may effect the satisfaction and compliableness of the decision makers (for examplepatients), which can lead to medical disputes. Therefore, it can help to decrease decisionbias to explore the affecting factors and rules of medical risk decision-making. However,participates in foreign research were mostly graduates, and only a few of the studies tooknurses or patients as participates. Also, few domestic researches focused on medical riskdecision-making. Therefore, it is theoretical and practical to explore the preferences andaffecting factors of the medical risk decision makers.Objective1. Make it clear that how the “survival probability” and “time variable” affect nursesand patients when they making risky decisions. To provide reference for the form ofmedical information through exploring the least biased information framing. 2. To explore the impact of resilience on decision behavior of nurses and patients,further more, to discuss the improvement of strong resilience for one’s ability to makedecisions, which can provide theory for improving the quality of medical decision.MethodsInvestigation method was used in the paper to explore the influence of informationframing and resilience on risky decision-making behavior of nurses and patients.1. The establishment of questionnaires. Two postgraduates of English major wereasked to translate the “survival probability” questionnaire of Thomas and the “timevariable” of Almashat. Then the questionnaires were read by two clinical experts torevise.2. A survey was conducted among nurses and patients from three top threeconvenient hospitals selected by stratified random sampling method.3. Participates were divided into “high score group” and “low score group”according to the “Evaluating Resiliency89” score.27%was used as line of demarcationto compare the decision behavior. SPSS18.0was used to do Statistics and data analysis,among which General statistical description and chi-square test were used.Outcome1. The “survival probability” information framing(1)The baseline of participates’ risky preference was all risky seeking for nurses andpatients, and the risky choice proportion was68.6%and68.8%.(2)In both doctors and patients the “absolute risks” format was similar to thebaseline, participates who prefer the new drug more effective was76.9%and76.5%. Itshowed that the “absolute risks” is the least biased format.2. The “time variable” information framing(1)The “cumulative probability” framing: both nurses and patients showed “framingeffect”, in other words, participates prefered the conservative treatment when theyreceived the positive information framing, while they showed more risky when receivingthe negative information framing. The proportion proving a surgery in the positiveframing was50.6%and48.1%, which was68.4%and69.4%in the negative framing. (2)The “interval probability” framing: both nurses and patients showed “framingeffect”. The proportion proving a surgery in the positive framing was40.2%and50.5%,which was76.3%and69.8%in the negative framing.(30The “life expectancy” framing: nither nurses nor patients showed “framingeffect”. The proportion proving a surgery in the positive framing was80.0%and72.4%,which was79.7%and72.2%in the negative framing.3. The effect of information framing and resilience(1)Nurses with high resilience showed more risk seeking behavior in“comprehensive information”、“absolute survival” and “absolute mortality” framing.The risky choice proportion was77.1%、69.2%and81.1%. Patients with high resilienceshowed more risk seeking behavior in “comprehensive information” and “relativemortality reduction” framing, and the risky choice proportion was78.6%and86.7%.(2)Both nurses and patients with high resilience showed more risk seeking behaviorin the negative format of the “time variable” information framing. The risky choiceproportion of nurses was81.0%、82.6%and84.6%, which was85.7%、92.9%and82.4%for patients.Conclusion1. The “survival probability” information framing(1)The baseline of participates’risky preference was all risky seeking for nurses andpatients.(2)As the “absolute risks” was the least biased format, it was worth recommended.2. The “time variable” information framingNither nurses nor patients showed “framing effect” in the “life expectancy” framing,which indicated that the “life expectancy” can avoid the effect of the positive or negativeinformation format. So, the “life expectancy” was worth recommended.3. The effect of information framing and resiliencePeople with high resilience preferred more risky choice, which was significant in“comprehensive information”、“absolute survival” and “absolute mortality” framing fornurses. Also, it was significant in “comprehensive information” and “relative mortality reduction” framing for patients. Besides, People with high resilience preferred morerisky choice in the negative format of the “time variable” information framing, whichstated that the influence of resilience is more significant in the negative format of the“time variable” information framing.