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Framing and personalizing informed consent to prevent negative expectations: An experimental pilot study.

Sarah R Heisig1, Meike C Shedden-Mora1, Pablo Hidalgo1

  • 1Institute of Psychology, Clinical Psychology and Psychotherapy, University of Hamburg.

Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association
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Summary

Optimizing informed consent for cancer treatments can improve patient expectations. Framing information with benefits and personalizing delivery reduces negative side effects and decision conflicts for endocrine therapy and chemotherapy.

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Area of Science:

  • Medical Psychology
  • Oncology
  • Health Communication

Background:

  • Informing patients about medical treatments is essential but can lead to negative expectations and nocebo effects.
  • Adjuvant breast cancer treatments like endocrine therapy and chemotherapy require careful patient communication.

Purpose of the Study:

  • To investigate how different informed consent procedures impact patient expectations for adjuvant breast cancer treatments.
  • To assess the influence of framing (with/without benefits) and personalization of information on necessity-concern beliefs, side-effect expectations, and decisional conflicts.

Main Methods:

  • A pilot study with a 2-factorial experimental design involving healthy women.
  • Participants were presented with hypothetical scenarios of endocrine therapy (n=60) or chemotherapy (n=64).
  • Information was framed with or without treatment benefits and delivered in a personalized or standardized manner.

Main Results:

  • Framing treatment information reduced side-effect expectations and decisional conflicts in endocrine therapy.
  • Personalized information led to more functional necessity-concern beliefs and lower decisional conflicts for endocrine therapy.
  • Combined framing and personalization most effectively improved necessity-concern beliefs and reduced decisional conflicts.
  • Framing improved necessity-concern beliefs for chemotherapy, and personalization reduced decisional conflicts, but no differences in side-effect expectations were found.

Conclusions:

  • Altered informed consent strategies, specifically framing and personalization, can positively influence treatment expectations and decrease decisional conflicts.
  • These findings suggest a potential method to mitigate nocebo responses in clinical practice.
  • Further research is needed to generalize these findings due to the pilot nature of the study.