Steckelberg Anke, Kasper Jürgen, Mühlhauser Ingrid
University of Hamburg, Unit of Health Sciences and Education, Hamburg, Germany.
Ger Med Sci. 2007 Aug 27;5:Doc05.
Evidence-based patient information (EBPI) is a prerequisite for informed decision-making. However, presentation of EBPI may lead to irrational reactions causing avoidance, minimisation and devaluation of the information.
To explore whether the theory of cognitive dissonance is applicable to medical decision-making and useful to explain these phenomena.
261 volunteers from Hamburg (157 women), >or=50 years old without diagnosis of colorectal cancer. DESIGN AND VARIABLES: Within an experiment we simulated information seeking on colorectal cancer screening. Consumers' attitudes towards screening were surveyed using a rating scale from -5 (participate in no way) to +5 (participate unconditionally) (independent variable). Using a cover story, participants were asked to sort 5 article headlines according to their reading preferences. The headlines simulated the pro to contra variety of contents to be found in print media about colorectal cancer screening. The dependent variable was the sequence of article headlines.
Participants were very much in favour of screening with scores for faecal occult blood test of 4.0 (0.1) and for colonoscopy 3.3 (0.1). According to our hypothesis we found statistically significant positive correlations between the stimuli in favour of screening and attitudes and significant negative correlations between the stimuli against screening and attitudes.
The theory of cognitive dissonance is applicable to medical decision-making. It may explain some phenomena of irrational reactions to evidence-based patient information.
循证患者信息（EBPI）是做出明智决策的前提条件。然而，EBPI的呈现可能会引发非理性反应，导致对信息的回避、轻视和贬低。
探讨认知失调理论是否适用于医疗决策，以及是否有助于解释这些现象。
来自汉堡的261名志愿者（157名女性），年龄≥50岁，未被诊断为结直肠癌。
在一项实验中，我们模拟了结直肠癌筛查的信息搜索过程。使用从-5（绝不参与）到+5（无条件参与）的评分量表对消费者对筛查的态度进行了调查（自变量）。通过一个掩饰故事，要求参与者根据他们的阅读偏好对5篇文章标题进行排序。这些标题模拟了印刷媒体上关于结直肠癌筛查的各种支持与反对的内容。因变量是文章标题的排序顺序。
参与者非常支持筛查，粪便潜血试验的得分是4.0（0.1），结肠镜检查的得分是3.3（0.1）。根据我们的假设，我们发现支持筛查的刺激因素与态度之间存在统计学上显著的正相关，而反对筛查的刺激因素与态度之间存在显著的负相关。
认知失调理论适用于医疗决策。它可能解释了对循证患者信息的一些非理性反应现象。
