Okvir i naziv medicinskog tretmana i njihov uticaj na zdravstvene odluke

  • Kaja Damnjanović Univerzitet u Beogradu, Filozofski fakultet, Odeljenje za psihologiju, Laboratorija za eksperimentalnu psihologiju
  • Sandra Ilić Univerzitet u Beogradu, Filozofski fakultet, Odeljenje za psihologiju, Laboratorija za eksperimentalnu psihologiju
  • Predrag Teovanović Univerzitet u Beogradu, Fakultet za specijalnu edukaciju i rehabilitaciju
Ključne reči: health decision||, ||zdravstvena odluka, shared decision making||, ||zajedničko odlučivanje, risky choice||, ||rizični izbor, framing effect||, ||efekat okvira, medical treatment||, ||medicinski tretman, surgery||, ||hirurška intervencija, radiation||, ||zračna terapija, prospect theory||, ||teorija izgleda, fuzzy-trace theory||, ||teorija mutnih tragova, patient||, ||pacijent,

Sažetak


Odluke o ličnom zdravlju protežu se od svakodnevnih i lakih, kao što je odluka o uzimanju vitaminskog suplementa, do onih koje se donose u situacijama kada je prisutna životno ugrožavajuća bolest. Pacijenti koji donose odluku o izboru tretmana suočavaju se sa specifičnim izazovima i imaju poteškoća da razumeju statističke podatke o mogućim ishodima alternativnih tretmana, o verovatnoći i o rizicima. Ova problematika je posebno značajna u kontekstu prakse zajedničkog odlučivanja, u kojoj i pacijent, a ne samo lekar, donosi odluku o tome na koji način će se tretirati bolest. Cilj ove studije bio je da se ispita uticaj naziva tretmana u zadacima odlučivanja u uslovima rizika. Efekat okvira rizičnog izbora se odnosi na sistematsku promenu redosleda preferencija koje su različite po rizičnosti. Do toga dolazi usled naglašavanja različitih aspekata identične situacije prilikom prikazivanja opcija donosiocima odluka. U našoj studiji ispitanici su prinudno birali između nerizičnog i rizičnog tretmana, koji su predstavljeni u terminima dobitka i gubitka. U prvoj eksperimentalnoj situaciji, kao rizična opcija predstavljena je operacija, a u drugoj zračenje. U trećem eksperimentu, nazivi tretmana su zamenjeni apstraktnim oznakama A i B. Rezultati pokazuju statistički značajnu razliku u proporcijama rizičnih odgovora između tri eksperimentalne situacije. Efekat okvira je registrovan u prvom i drugom eksperimentu; u prvom umerenog, a u drugom većeg intenziteta. Kada biraju između operacije i zračenja na ispitanike utiče naziv tretmana, ali to ne objašnjava celokupnu varijansu. Po pravilu, preferirali su operaciju, a kada je ona prikazana u terminima gubitka, ta preferencija je bila još jača.

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2020/01/14
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