Winterbottom Anna, Bekker Hilary L, Conner Mark, Mooney Andrew
School of Medicine, University of Leeds, Leeds, West Yorkshire LS2 9JT, UK. anna.winterbottom.co.uk
Soc Sci Med. 2008 Dec;67(12):2079-88. doi: 10.1016/j.socscimed.2008.09.037. Epub 2008 Oct 24.
Including narratives in health-care interventions is increasingly popular. However, narrative information may bias individual's decision making, resulting in patients making poorer decisions. This systematic review synthesises the evidence about the persuasiveness of narrative information on individuals' decision making. Seventeen studies met the review criteria; 41% of studies employed first person narration, 59% third person. Narrative information influenced decision making more than the provision of no additional information and/or statistically based information in approximately a third of the studies (5/17); studies employing first person narratives were twice as likely to find an effect. There was some evidence that narrative information encouraged the use of heuristic rather than systematic processing. However, there was little consistency in the methods employed and the narratives' content to provide evidence on why narratives affect the decision process and outcome, whether narratives facilitate or bias decision making, and/or whether narratives affect the quality of the decision being made. Until evidence is provided on why and how narratives influence decision making, the use of narratives in interventions to facilitate medical decision making should be treated cautiously.
在医疗保健干预措施中纳入叙事内容越来越普遍。然而，叙事信息可能会使个体的决策产生偏差，导致患者做出更糟糕的决策。本系统评价综合了关于叙事信息对个体决策说服力的证据。17项研究符合评价标准；41%的研究采用第一人称叙述，59%采用第三人称。在大约三分之一的研究（5/17）中，叙事信息比不提供额外信息和/或基于统计的信息对决策的影响更大；采用第一人称叙事的研究发现有影响的可能性是其他研究的两倍。有证据表明，叙事信息鼓励使用启发式而非系统性处理方式。然而，在所采用的方法和叙事内容方面几乎没有一致性，无法为叙事为何影响决策过程和结果、叙事是促进还是使决策产生偏差，以及/或者叙事是否影响所做决策的质量提供证据。在提供关于叙事为何以及如何影响决策的证据之前，在促进医疗决策的干预措施中使用叙事应谨慎对待。
