Institute of Primary Care and Public Health, Cardiff University, UK.
Patient Educ Couns. 2012 Aug;88(2):256-61. doi: 10.1016/j.pec.2012.03.002. Epub 2012 Apr 1.
To develop a framework of decision making and coping in healthcare that describes the twin processes of appraisal and coping faced by patients making preference-sensitive healthcare decisions.
We briefly review the literature for decision making theories and coping theories applicable to preference-sensitive decisions in healthcare settings. We describe first decision making, then coping and finally attempt to integrate these processes by building on current theory.
Deliberation in healthcare may be described as a six step process, comprised of the presentation of a health threat, choice, options, preference construction, the decision itself and consolidation post-decision. Coping can be depicted in three stages, beginning with a threat, followed by primary and secondary appraisal and ultimately resulting in a coping effort.
Drawing together concepts from prominent decision making theories and coping theories, we propose a multidimensional, interactive framework which integrates both processes and describes coping in deliberation.
The proposed framework offers an insight into the complexity of decision making in preference-sensitive healthcare contexts from a patient perspective and may act as theoretical basis for decision support.
构建一个医疗保健决策与应对框架，描述在进行偏好敏感型医疗保健决策时，患者所面临的评估和应对这两个双重过程。
我们简要回顾了适用于医疗保健环境中偏好敏感型决策的决策理论和应对理论的文献。我们首先描述决策过程，然后描述应对过程，最后尝试通过现有理论来整合这些过程。
医疗保健中的深思熟虑可以描述为一个六步过程，包括健康威胁的呈现、选择、选项、偏好构建、决策本身以及决策后的巩固。应对可以分为三个阶段，从威胁开始，然后是初级和次级评估，最终产生应对努力。
我们从突出的决策理论和应对理论中汲取概念，提出了一个多维、互动的框架，整合了这两个过程，并描述了在深思熟虑中的应对。
从患者的角度来看，所提出的框架深入了解了偏好敏感型医疗保健背景下的决策复杂性，并可能作为决策支持的理论基础。
