Alden Dana L, Friend John M, Lee Angela Y, de Vries Marieke, Osawa Ryosuke, Chen Qimei
Department of Marketing.
Department of Social Psychology.
Health Psychol. 2015 Dec;34(12):1133-44. doi: 10.1037/hea0000229. Epub 2015 Jun 15.
Two studies identified core value influences on medical decision-making processes across and within cultures.
In Study 1, Japanese and American adults reported desired levels of medical decision-making influence across conditions that varied in seriousness. Cultural antecedents (interdependence, independence, and power distance) were also measured. In Study 2, American adults reviewed a colorectal cancer screening decision aid. Decision preparedness was measured along with interdependence, independence, and desire for medical information.
In Study 1, higher interdependence predicted stronger desire for decision-making information in both countries, but was significantly stronger in Japan. The path from information desire to decision-making influence desire was significant only in Japan. The independence path to desire for decision-making influence was significant only in the United States. Power distance effects negatively predicted desire for decision-making influence only in the United States. For Study 2, high (low) interdependents and women (men) in the United States felt that a colorectal cancer screening decision aid helped prepare them more (less) for a medical consultation. Low interdependent men were at significantly higher risk for low decision preparedness.
Study 1 suggests that Japanese participants may tend to view medical decision-making influence as an interdependent, information sharing exchange, whereas American respondents may be more interested in power sharing that emphasizes greater independence. Study 2 demonstrates the need to assess value influences on medical decision-making processes within and across cultures and suggests that individually tailored versions of decision aids may optimize decision preparedness.
两项研究确定了跨文化和文化内部核心价值观对医疗决策过程的影响。
在研究1中，日本和美国成年人报告了在不同严重程度条件下对医疗决策影响的期望水平。还测量了文化前因（相互依存、独立和权力距离）。在研究2中，美国成年人审查了一份结直肠癌筛查决策辅助工具。测量了决策准备程度以及相互依存、独立和对医疗信息的渴望程度。
在研究1中，更高的相互依存度预示着两国对决策信息的更强烈渴望，但在日本更为显著。从信息渴望到决策影响渴望的路径仅在日本显著。从独立到决策影响渴望的路径仅在美国显著。权力距离效应仅在美国对决策影响渴望的预测上呈负相关。对于研究2，美国高（低）相互依存者和女性（男性）认为结直肠癌筛查决策辅助工具能让他们为医疗咨询做更多（更少）准备。低相互依存的男性决策准备不足的风险显著更高。
研究1表明，日本参与者可能倾向于将医疗决策影响视为一种相互依存的信息共享交流，而美国受访者可能对强调更大独立性的权力共享更感兴趣。研究2表明需要评估跨文化和文化内部价值观对医疗决策过程的影响，并表明针对个体定制的决策辅助工具版本可能会优化决策准备程度。
