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How do women make decisions about hormone replacement therapy?
Dawn M Bravata1, Asghar Rastegar, Ralph I Horwitz
1Internal Medicine, VA Connecticut Healthcare System, Yale University School of Medicine, 333 Cedar Street, West Haven, CT 06520-8025, USA. dawn.bravata@yale.edu
The American Journal of Medicine
|July 11, 2002
Summary
This study explores how women decide on hormone replacement therapy, identifying key clinician roles in patient decision-making. A new model highlights information, attention, health perception, and narrative as crucial factors.
Area of Science:
- Medical Decision Making
- Health Psychology
- Patient-Centered Care
Background:
- Clinicians are expected to involve patients in decision-making, but guidance is limited.
- Understanding patient decision processes is crucial for effective clinical support.
- Hormone replacement therapy (HRT) decisions offer a relevant context for this research.
Purpose of the Study:
- To investigate patient decision-making processes.
- To identify the role of clinicians in supporting patient choices.
- To develop a model of patient decision-making in the context of HRT.
Main Methods:
- Qualitative study involving 23 women deciding on HRT.
- Semistructured interviews with open-ended questions.
- Thematic analysis of transcribed interviews to identify decision-making processes.
Main Results:
- A model of patient decision-making was developed, outlining common processes.
- Four key areas for clinician influence were identified: information provision, selective attention, health perception, and narrative development.
- Patient statements were categorized into nine descriptive themes.
Conclusions:
- The developed model enhances understanding of complex patient decision-making.
- Clinicians can support patients by focusing on information, attention, perception, and narrative.
- Further research is needed to test the model's generalizability across different patient groups and decisions.