时间变量信息框架对护士和患者风险决策行为的影响

Influence of time variable information framing on risk decision-making behaviors of nurses and patients

目的探讨时间变量信息框架对护士和患者风险决策行为的影响。方法采用6种时间变量信息框架问卷对西安市3所三级甲等医院的474名在职护士和627例患者进行分层抽样调查。结果①"累计生存时间""区间生存时间"框架下,护士和患者决策均出现"框架效应"现象,即呈现正面信息时保守、负面信息时冒险。前者正面信息刺激下护士和患者支持手术的人数比例为50.63%、48.15%;负面为68.35%、69.44%。后者正面信息下护士和患者支持手术为40.24%、50.51%;负面为76.25%、69.81%,差异具有统计学意义(P<0.01或P<0.05)。②"平均预期寿命"框架下,护士和患者决策均未出现"框架效应"现象。③"时间变量"信息框架下护士与患者风险决策比较差异无统计学意义(P>0.05)。结论 "平均预期寿命"的表述方式能够规避正面或负面不同表述角度的影响,是值得推荐的医疗决策信息表述方式。

Objective To explore the influence of different time variable information framing on risky decision - making behaviors of nurses and patients. Methods A stratified sampling investigation was conducted among 474 nurses and 627 patients from three 3A - level hospitals in Xi＇an using the questionnaire of different time variable information framing. Results ①Under the frames of ＂ cumulative probability＂ and ＂ interval probability＂ , both nurses and patients showed ＂framing effect＂ ,in other words, participates preferred conservative treatment when they received positive information, while they showed more risky when receiving negative information. In the frame of ＂ cumulative probability＂ , the proportion supporting a surgery of nurses and patients in positive framing was 50.63% and 48.15% , which were 68.35% and 69.44% in negative framing;While in the frame of ＂interval probability＂, the proportion supporting a surgery of nurses and patients in positive framing was 40.24% and 50.51% ,which were 76.25% and 69.81% in negative framing,the differences were statistically significant （P 〈0.01 or P 〈0.05 ）.②Under the frame of ＂ average life expectancy＂ ,both nurses and patients showed no ＂framing effect＂. ③There existed no differences in risk decision - making between nurses and patients under different time variable information framing （ P 〉 0.05 ）. Conclusion The expression of ＂ average life expectancy＂ can avoid the influences of both expressions of positive or negative information format, and it is a recommendable expression of medical decision - making information.