Health Care, Technology and Place CIHR Strategic Training Program, University of Toronto, Toronto, Canada.
Health Expect. 2011 Jun;14(2):115-32. doi: 10.1111/j.1369-7625.2010.00618.x. Epub 2010 Oct 28.
To combine insights from multiple disciplines into a set of questions that can be used to investigate contextual factors affecting health decision making.
Decision-making processes and outcomes may be shaped by a range of non-medical or 'contextual' factors particular to an individual including social, economic, political, geographical and institutional conditions. Research concerning contextual factors occurs across many disciplines and theoretical domains, but few conceptual tools have attempted to integrate and translate this wide-ranging research for health decision-making purposes.
To formulate this tool we employed an iterative, collaborative process of scenario development and question generation. Five hypothetical health decision-making scenarios (preventative, screening, curative, supportive and palliative) were developed and used to generate a set of exploratory questions that aim to highlight potential contextual factors across a range of health decisions.
We present an exploratory tool consisting of questions organized into four thematic domains - Bodies, Technologies, Place and Work (BTPW) - articulating wide-ranging contextual factors relevant to health decision making. The BTPW tool encompasses health-related scholarship and research from a range of disciplines pertinent to health decision making, and identifies concrete points of intersection between its four thematic domains. Examples of the practical application of the questions are also provided.
These exploratory questions provide an interdisciplinary toolkit for identifying the complex contextual factors affecting decision making. The set of questions comprised by the BTPW tool may be applied wholly or partially in the context of clinical practice, policy development and health-related research.
将多个学科的见解结合起来，形成一组可用于研究影响健康决策的情境因素的问题。
决策过程和结果可能受到一系列特定于个体的非医学或“情境”因素的影响，包括社会、经济、政治、地理和制度条件。涉及情境因素的研究涉及许多学科和理论领域，但很少有概念工具试图为健康决策目的整合和翻译这广泛的研究。
为了制定这个工具，我们采用了一种迭代的、协作的情景开发和问题生成过程。开发了五个假设的健康决策情景（预防性、筛查性、治疗性、支持性和姑息性），并使用这些情景生成了一组探索性问题，旨在突出一系列健康决策中的潜在情境因素。
我们提出了一个由问题组成的探索性工具，这些问题组织成四个主题领域 - 身体、技术、地点和工作（BTPW） - 阐明了与健康决策相关的广泛情境因素。BTPW 工具包含了与健康决策相关的来自多个学科的学术研究，确定了其四个主题领域之间的具体交叉点。还提供了问题实际应用的示例。
这些探索性问题为确定影响决策的复杂情境因素提供了一个跨学科的工具包。BTPW 工具中的问题集可以在临床实践、政策制定和健康相关研究的背景下全部或部分应用。
