Seite - 112 - in Applied Interdisciplinary Theory in Health Informatics - Knowledge Base for Practitioners
Bild der Seite - 112 -
Text der Seite - 112 -
facing) on the basis of available information and resources. In this way people are often
able to make smart decisions without elaborate deliberation, using intuitive processes
that are based on learned patterns and relevant priors.
Boosts are tools that are based on this optimistic assumption that people have the
capacity to learn, and support people in increasing their competence to make good
decisions. These boosts can take various shapes, such as simply providing information
(e.g., about illness); strategies to make information more easy to understand; tools or
skills-training to help clarify the values of decision alternatives (e.g., how to integrate
information according to your values); self-management skills (e.g., knowing when and
how to act within treatment or revalidation; knowing how to make implementation
intentions); social skills (e.g., how to approach another person during an important
conversation) and others. These boosts can be domain specific (e.g., health information
about a certain illness) or more general (e.g., strategies to improve statistical literacy).
As we will explain in more detail in section 2, boosts can improve health related
decisions. For example, these boosts increase competence by helping patients to
understand risk information or to make decisions in line with one’s core values.
1.2. Autonomy and well-being
Boosts make people more competent. Therefore, by definition, boosts are
beneficial for the individual. In addition, increased competences have positive effects on
psychological processes including motivation, autonomy and well-being. For example,
improved knowledge enhances self-efficacy, i.e., the core belief in the ability to achieve
self-relevant goals. Subsequently, people with high efficacy may display stronger
motivation; e.g., persist longer in the face of obstacles [8]. More generally, this way,
boosts may increase feelings of autonomy and well-being.
People are often not aware
that they are being nudged. Instead, they depend on the good intentions of the “nudger”,
e.g., healthcare providers, the government, institutions and companies, acting as a so-
called “benevolent dictator”. The goals of nudgers are not necessarily consistent with the
goals of the decision maker. This is crystal clear when nudging is used for commercial
purposes, but even when the government or healthcare providers operate as nudgers,
goals may not converge with the values of an individual, and hence, may have a negative
impact on the well-being of those being nudged. Therefore, nudging may be considered
the best approach only when 1) there is great consensus among individuals within society
concerning the necessity of behaviour change and 2) individuals are not motivated or
able to learn skills to change this behaviour [9].
When the values or preferences of individuals are highly heterogeneous and good
choices fully depend on people’s own values, boosting clearly outperforms nudging. In
cases in which the values of the person are not known, nudging is like playing roulette,
whereas boosting could help people to integrate their own values in a choice. Thus, as
Hertwig [9] indicates, when individual values are at stake, boosting is strongly preferred
to nudging. This is often the case in health-related decision making, where there is likely
to be a balance between the benefits and harms of different options (decisional equipoise)
and/or decisions are preference sensitive because of the variation of how people value
attributes of different options. People may have strong feelings about decisions where
the best option seems obvious, e.g., removing the contralateral breast in women with
average breast cancer has no mortality benefit but an individual woman may still prefer
it because she wants to feel balanced. Some scholars argue that all health decisions are
M.deVriesetal. /FosteringSharedDecisionMakingwithHealth Informatics
Interventions112
zurück zum
Buch Applied Interdisciplinary Theory in Health Informatics - Knowledge Base for Practitioners"
Applied Interdisciplinary Theory in Health Informatics
Knowledge Base for Practitioners
- Titel
- Applied Interdisciplinary Theory in Health Informatics
- Untertitel
- Knowledge Base for Practitioners
- Autoren
- Philip Scott
- Nicolette de Keizer
- Andrew Georgiou
- Verlag
- IOS Press BV
- Ort
- Amsterdam
- Datum
- 2019
- Sprache
- englisch
- Lizenz
- CC BY-NC 4.0
- ISBN
- 978-1-61499-991-1
- Abmessungen
- 16.0 x 24.0 cm
- Seiten
- 242
- Kategorie
- Informatik