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The purpose of this paper is to investigate how managers in social and health care evaluate the knowledge sources affecting their decision‐making, and how the evaluations were associated with the managers' professional background, activity sector, gender, age and management experience.

The study data are gathered from a questionnaire survey to the middle‐line doctor, nurse and social managers (n=404) within the responsibility area of a Finnish university hospital. Assessed the proportions of individual knowledge sources in the complete data set and their associations with the subjects' background data. In addition, grouping of individual knowledge sources variables are made using factor analysis.

The findings indicate that social and health care managers attempt to utilize diverse knowledge sources. Overall, professional experience and education, organization budget, and action plans of one's own unit are estimated as knowledge sources with the greatest impact. Manager's professional background and activity sector are associated with the kind of knowledge affecting their decision‐making. Some differences are noted between genders, but differences with respect to age or management experience are non‐significant.

Social and health care organizations represent expert organizations where decision‐making is steered by professions and management tasks.

This paper suggests that the future decision‐makers will be required to identify versatile knowledge areas across cultural barriers, and to be capable of making comprehensive decisions affecting the entire organization.

Consumers have increased access to digital health tools such as social media, websites and marketer-controlled platforms for information sharing. Telemedicine (TM) represents an emerging omni-channel touchpoint for consumers to exchange information and inform health decision-making at a time and place of their choosing. While TM offers great potential, consumer adoption has been slower than expected. This paper aims to investigate attitudinal factors that influence adoption and usage of TM within consumers’ omni-channel decision-making environment.

Surveys from 869 patients were analyzed using multiple linear regression to examine the relationships between health decision-making, TM access benefits and omni-channel touchpoints (social media, website and internal health digital channels usage) on TM usage likelihood.

Attitudinal constructs related to TM’s benefits including access and health decision-making have the strongest impact on future TM usage. The study also empirically demonstrates a link between consumers’ omni-channel information seeking and TM usage.

Increasing consumers’ involvement across omni-channel touchpoints has an additive effect on perceived benefits for engaging consumers in using digital offerings like TM. Future research is needed that examines the interrelationships on consumers’ health decision-making across generational cohorts and the post-adoption effects of digital service offerings.

Omni-channel touchpoints such as TM provide new opportunities to enhance shared decision-making. However, marketers need to adopt strategies that accommodate consumers’ evolving omni-channel preferences for access and information exchange to synergize digital service offerings with interpersonal touchpoints.

This study integrates shared decision-making, technology acceptance and omni-channel marketing literature to explore TM acceptance and usage within the context of consumers’ omni-channel decision process.

Faced with an ageing population and newspaper warnings that escalating costs are leading to a health crisis, debate has intensified in Australia and elsewhere on the allocation of limited health resources. But whose values should inform decision‐making in the health area, and should the influence of different groups vary with the level of decision‐making? These questions were put to 54 members of the public and health professionals in eight focus groups. Unlike previous studies, participants were not asked if particular groups should be involved in decisions but rather through deliberation and discussion nominated their own potential decision‐makers. This delivered a clear message that participants saw a legitimate role for a broad range of stakeholders in priority‐setting decisions. The results suggest that qualitative methods of investigation have the potential to improve the legitimacy and accountability of policy decisions by contributing to a better understanding of the values of the public and health professionals.

The purpose of this paper is to understand how women with a diagnosis of schizophrenia or bipolar disorder approach medication decision making in pregnancy.

The study was co-produced by university academics and charity-based researchers. Semi-structured interviews were conducted by three peer researchers who have used anti-psychotic medication and were of child bearing age. Participants were women with children under five, who had taken anti-psychotic medication in the 12 months before pregnancy. In total, 12 women were recruited through social media and snowball techniques. Data were analyzed following a three-stage process.

The accounts highlighted decisional uncertainty, with medication decisions situated among multiple sources of influence from self and others. Women retained strong feelings of personal ownership for their decisions, whilst also seeking out clinical opinion and accepting they had constrained choices. Two styles of decision making emerged: shared and independent. Shared decision making involved open discussion, active permission seeking, negotiation and coercion. Independent women-led decision making was not always congruent with medical opinion, increasing pressure on women and impacting pregnancy experiences. A common sense self-regulation model explaining management of health threats resonated with women’s accounts.

Women should be helped to manage decisional conflict and the emotional impact of decision making including long term feelings of guilt. Women experienced interactions with clinicians as lacking opportunities for enhanced support except in specialist perinatal services. This is an area that should be considered in staff training, supervision, appraisal and organization review.

This paper uses data collected in a co-produced research study including peer researchers.

The purpose of this paper is to explore and assess barriers and opportunities for evidence-based management (EBMgt) and decision-making in healthcare systems of the small island developing states (SIDSs) of English-speaking Caribbean.

The study utilized grounded theory to collect and analyze data on experiences and perceptions of 20 senior managers/leaders from seven Ministries of health in the region. It used semi-structured, in-depth interviews comprising open-ended questions. Data analysis comprised open, focused and theoretical coding.

EBMgt and decision-making is not a prominent approach taken by top officials of health systems because of internal and external barriers to its use. Indeed the absence of a culture of decision-making based on evidence pervades the public services of Caribbean island states. Notwithstanding, there are opportunities for meaningful application of this management/leadership strategy.

To the author’s knowledge, this is the first assessment of the application of EBMgt to health systems of SIDSs of the Caribbean. This paper is concerned with the approach to decision-making in health systems across island states and lends support to the use of evidence in decision-making and policy development. It provides useful direction for policy makers, and senior managers/leaders of these systems.

Purpose – This chapter offers an integrative review of psychological and neurobiological differences between younger and older adults that might impact economic behavior. Focusing on key health economic challenges facing the elderly, it offers perspectives on how these psychological and neurobiological factors may influence decision-making over the life course and considers future interdisciplinary research directions.

Methodology/approach – We review relevant literature from three domains that are essential for developing a comprehensive science of decision-making and economic behavior in aging (psychology, neuroscience, and economics), consider implications for prescription drug coverage and long-term care (LTC) insurance, and highlight future research directions.

Findings – Older adults face many complex economic decisions that directly affect their health and well-being, including LTC insurance, prescription drug plans, and end of life care. Economic research suggests that many older Americans are not making cost-effective and economically rational decisions. While economic models provide insight into some of the financial incentives associated with these decisions, they typically do not consider the roles of cognition and affect in decision-making. Research has established that older age is associated with predictable declines in many cognitive functions and evidence is accumulating that distinct social motives and affect-processing profiles emerge in older age. It is unknown how these age differences impact the economic behaviors of older people and implies opportunities for path-breaking interdisciplinary research.

Originality/value of the chapter – Our chapter looks to develop interdisciplinary research to better understand the causes and consequences of age-related changes in economic decision-making and guide interventions to improve public programs and overall social welfare.

The relatively recent attention that evidence-based decision making has received in health care management has been at least in part due to the profound influence of evidence-based medicine. The result has been several comparisons in the literature between the use of evidence in health care management decisions and the use of evidence in medical decision making. Direct comparison, however, may be problematic, given the differences between medicine and management as they relate to (1) the nature of evidence that is brought to bear on decision making; (2) the maturity of empirical research in each field (in particular, studies that have substantiated whether or not and how evidence-based decision making is enacted); and (3) the context within which evidence-based decisions are made. By simultaneously reviewing evidence-based medicine and management, this chapter aims to inform future theorizing and empirical research on evidence-based decision making in health care settings.

This qualitative study explores how individuals understand health insurance concepts and make health insurance purchase decisions. The study sought to develop a model of the health insurance decision-making process.

This study used semi-structured interview questions and the micro-moment time-line interview technique with newly hired employees to discuss the steps that individuals follow when making health insurance decisions. The researcher used an open coding approach to analyze the steps listed by each participant, and emergent themes were used to code all interview transcripts in Atlas.ti.

This study identified information tactics used by individuals when evaluating health insurance documentation. The findings also shed light on the personal reflection individuals undertake when making their health insurance choices.

The information needs and preferred information sources identified in this study will be of interest to information professionals and human resources officers providing assistance with health insurance enrolment.

The findings demonstrating that participants characterized their health insurance choice as a shared decision is a novel contribution of this study.

Shared decision making (SDM) is a model of health care in which patients are involved in the decision-making process about their treatment, considering their preferences and concerns in a deliberative process with the health care provider. Many existing instruments assess the antecedents, process, or the outcomes of SDM. The purpose of this paper is to identify the SDM-related measures applied in a mental health context.

The authors performed a systematic review in several electronic databases from 1990 to October 2016. Studies that assessed quantitatively one or more constructs related to SDM (antecedents, process, and outcomes) in the field of mental health were included.

The authors included 87 studies that applied 48 measures on distinct SDM constructs. A large majority of them have been developed in the field of physical diseases and adapted or directly applied in the mental health context. The most evaluated construct is the SDM process in consultation, mainly by patients’ self-report but also by external observer measures, followed by the patients’ preferences for involvement in decision making. The most applied instrument was the Autonomy Preference Index, followed by the Observing Patient Involvement in Decision Making (OPTION) and the Control Preferences Scale (CPS). The psychometric validation in mental health samples of the instruments identified is scarce.

The bibliographic search is comprehensive, but could not be completely exhaustive. Effort should be invested in the development of new SDM for mental health tools that will reflect the complexity and specific features of mental health care.

The authors highlight several limitations and challenges for the measurement of SDM in mental health care.

Encouraging patient involvement is a cornerstone of many healthcare interventions and decision-making models to ensure that treatment decisions reflect the needs, values, and desires of patients. Involved patients are thought to be empowered patients who feel a sense of efficacy in regards to their own health. However, there is a lack of understanding of how patients relate to empowerment and involvement and, most importantly, how these constructs relate to one another in patients’ decision-making experiences.

Through an inductive analysis, this chapter draws on qualitative interviews of women diagnosed with breast cancer prior to 40 years of age (n = 69).

By examining the intersection of how patients define their own involvement in treatment decisions and their sense of empowerment, we find four orientations to decision-making (Advocates, Bystanders, Co-Pilots, and Downplayers) with involvement and empowerment being coupled for some respondents, but decoupled for others.

Our findings suggest expanding what it means to be an “active” patient as respondents had multiple ways of characterizing involvement, including being informed or following their doctor’s advice. Our findings also suggest a more critical examination of the origins and potential downsides of patient empowerment as some respondents reported feeling overwhelmed or pushed into advocacy roles. The sample was disproportionately higher socioeconomic status with limited racial/ethnic diversity. Empowerment and involvement may be enacted differently for other social groups and other medical conditions.

By examining first-person patient narratives, we conclude that patients’ experience may not fully align with current academic or clinical discussions of patient involvement or empowerment.