封面陈述与框架信息清晰度对脑梗死患者溶栓风险决策的影响

Influence of cover statement and clarity of messages upon risk decision making about thrombolysis therapy in patients with cerebral infarction

目的 在“急性脑梗死溶栓治疗”情境下,探讨封面陈述与框架信息清晰度对脑梗死患者溶栓风险决策的影响.方法 以2011年12月以后神经内科住院及门诊的脑梗死患者为研究对象,采用简单随机化方法将其分为详细封面陈述组（263人）和简单封面陈述组（278名）,每组被试均接受模糊信息和详细信息,被试只接受一种信息框架（正面/负面框架）.结果 在简单封面陈述组,无论是模糊信息组,还是在清晰信息组,被试均未受框架效应的影响,但均表现为风险寻求（溶栓治疗）（x^2=1.20,P＞0.05,x^2=0.15,P＞0.05）;在详细封面陈述组,清晰信息组被试未受框架效应影响（x^2=0.19,P＞0.05）,但在模糊信息组,被试受框架效应影响,而在正面框架中,表现为更为显著的风险寻求（x^2 =7.90,P＜0.01）.结论 封面陈述和框架信息清晰度会影响脑梗死患者的溶栓风险决策倾向,在溶栓治疗中,为提高溶栓率,建议给予详细封面陈述下的正面模糊信息框架.

Objective Influence of cover statement and clarity of the messages upon risk decision making about thrombolysis therapy in patients with cerebral infarction was discussed in the Scenarios of thrombolytic therapy for acute cerebral infarction.Methods Inpatients and outpatients with cerebral infarction were randomly divided into two groups：detailed / simple cover statement group.Every participant underwent obscure messages and clear messages with only one frame：positive or negative frame.Results In the simple cover statement group,both obscure messages subgroup and clear messages subgroup were not influenced by the framing effect with preference to the risk seeking.In the detailed cover statement group,participants in the clear messages group were not influenced by the framing effect（x^2 =0.19,P〉0.05）,while the subjects in the obscure messages group were actually affected by the framing effect,with the preference to risk seeking in the positive framework （x^2=7.90,P〈0.01）.Conclusion The risk decision making about thrombolysis therapy in patients with cerebral infarction is influenced by cover statements and clarity of the messages.To improve the rate of thrombolysis therapy,the patients should be exposed to the obscure messages in the positive framing information under the detailed cover statement.