Oomen J M H, van den Ende C H, Schers H J, Koëter S, Assendelft W J J, Das E
Department of Research and Innovation, Sint Maartenskliniek, PO Box 9011, 6500 GM, Nijmegen, the Netherlands.
Department of Primary and Community Care, Radboudumc, PO Box 9101, 6500 HB, Nijmegen, the Netherlands.
BMC Public Health. 2025 Jul 21;25(1):2517. doi: 10.1186/s12889-025-22436-6.
Recent findings show that intentions to adhere to conservative treatment of osteoarthritis are negatively influenced by certain beliefs and rely strongly on testimonies of others. Message framing, i.e., focusing on either gains or losses, and the use of a patient testimonial in educational material are commonly used techniques to influence beliefs, and ultimately, health behaviors.
To study the effects of 1) message framing and 2) patient testimonials on osteoarthritis patients' beliefs about and intentions to be physically active and to use pain medication.
Members of a research panel (n=639) with a self-reported diagnosis of knee OA were, after informed consent, randomly allocated to watching one out of four video messages combining a framing condition (gain or loss-frame) with the use of a testimonial (yes/no). After watching this video, participants completed a questionnaire on attitudes, behavioral beliefs, attitudes towards physical activity and pain medication (1=completely disagree, 7=completely agree), and intentions towards physical activity and pain medication (1=I do not do this now and am not planning on doing this, 7=I am doing this already for more than 6 months). ANOVA was used to assess the main and interaction effects.
A total of 154 respondents completed the questionnaire. Message framing and the use of a testimonial did not impact attitudes, beliefs, or intentions on physical activity. However, loss framing resulted in more positive attitudes towards pain medication (mean (SD) 5.5 (1.6)) than gain framing (mean (SD) 4.9 (1.9), mean difference=0.6, 95% CI [0.0, 1.1]). Furthermore, the patient testimonial induced more positive pain medication attitudes (mean (SD) 6.0 (1.1)) than the informative control message (mean (SD) 5.0 (1.7), mean difference=0.9, 95% CI [0.1, 1.6]) when the message used a loss, rather than a gain-frame.
This study suggests that describing the disadvantages of nonadherence to pain medication resulted in more positive beliefs about pain medication than stating the advantages of adherence. The use of a patient testimonial within this loss-frame strengthened the effect. Our findings indicate that the use of framing and testimonials in OA care can matter and that healthcare providers should be aware of the potential effects of emphasising either gains or losses in communicating with their patients.
最近的研究结果表明，坚持骨关节炎保守治疗的意愿会受到某些信念的负面影响，并且很大程度上依赖于他人的证词。信息框架构建，即关注收益或损失，以及在教育材料中使用患者证词，是影响信念并最终影响健康行为的常用技巧。
研究1）信息框架构建和2）患者证词对骨关节炎患者关于身体活动和使用止痛药的信念及意愿的影响。
在获得知情同意后，将自我报告诊断为膝关节骨关节炎的研究小组成员（n = 639）随机分配观看四段视频信息中的一段，这些视频信息将框架构建条件（收益或损失框架）与证词的使用（有/无）相结合。观看视频后，参与者完成一份关于态度、行为信念、对身体活动和止痛药的态度（1 = 完全不同意，7 = 完全同意）以及对身体活动和止痛药的意愿（1 = 我现在不这样做且不打算这样做，7 = 我已经这样做超过6个月）的问卷。使用方差分析来评估主要效应和交互效应。
共有154名受访者完成了问卷。信息框架构建和证词的使用并未影响对身体活动的态度、信念或意愿。然而，损失框架导致对止痛药的态度比收益框架更积极（均值（标准差）5.5（1.6））（收益框架均值（标准差）4.9（1.9），均值差异 = 0.6，95%置信区间[0.0, 1.1]）。此外，当信息使用损失框架而非收益框架时，患者证词比信息性对照信息诱导出更积极的止痛药态度（均值（标准差）6.0（1.1））（信息性对照信息均值（标准差）5.0（1.7），均值差异 = 0.9，95%置信区间[0.1, 1.6]）。
本研究表明，描述不坚持服用止痛药的弊端比陈述坚持服用的好处能使人们对止痛药产生更积极的信念。在这种损失框架内使用患者证词增强了这种效果。我们的研究结果表明，在骨关节炎护理中使用框架构建和证词可能很重要，医疗保健提供者应该意识到在与患者沟通中强调收益或损失的潜在影响。
