Unsworth C A, Thomas S A, Greenwood K M
School of Occupational Therapy, La Trobe University, Bundoora, Australia.
Int J Rehabil Res. 1997 Mar;20(1):51-69. doi: 10.1097/00004356-199703000-00005.
This study sought to identify if decision polarization effects were operating in rehabilitation teams when making discharge housing recommendations for stroke patients. Using a Social Judgment Theory approach, individual clinicians were asked to nominate discharge housing for stroke patients. Teams were then assembled and clinicians repeated the task. The research was conducted at a sample of seven in-patient rehabilitation hospitals. The subjects were 74 clinicians who formed 13 teams. All subjects were volunteers, and represented the following professions: medicine, nursing, occupational therapy, physical therapy, speech therapy, and social work. A casebook which described 50 hypothetical stroke patients in terms of eight attributes was devised for the study. Subjects made housing recommendations to these patients using a 7-point scale. When compared to individual clinicians' recommendations, it was found that team housing recommendations made by all 13 teams polarized towards both more supported and, in the other extreme, more independent types of housing. However, teams placed a stronger emphasis on supported housing when compared with individual clinician decisions. This decision polarization suggests that housing recommendations made to patients may reflect team processes as well as patient needs. Rehabilitation teams should be aware of this negative team dynamic so that steps to minimize decision polarization can be taken.
本研究旨在确定在为中风患者做出出院住房建议时，康复团队中是否存在决策两极分化效应。采用社会判断理论方法，要求个体临床医生为中风患者指定出院住房。然后组建团队，临床医生重复该任务。研究在七家住院康复医院的样本中进行。受试者为74名临床医生，他们组成了13个团队。所有受试者均为志愿者，代表以下专业：医学、护理、职业治疗、物理治疗、言语治疗和社会工作。为该研究设计了一本案例手册，根据八个属性描述了50名假设的中风患者。受试者使用7分制为这些患者提出住房建议。与个体临床医生的建议相比，发现所有13个团队做出的团队住房建议两极分化，倾向于更受支持的住房类型，而在另一个极端，则倾向于更独立的住房类型。然而，与个体临床医生的决定相比，团队更加强调支持性住房。这种决策两极分化表明，向患者提出的住房建议可能反映了团队流程以及患者需求。康复团队应该意识到这种负面的团队动态，以便采取措施尽量减少决策两极分化。
