Symptom appraisal in uncertainty: A theory-driven thematic analysis with survivors of childhood cancer

Objective: Somatic symptoms capture attention, demand interpretation, and promote health behaviors. Symptom appraisal is particularly impactful within uncertain health contexts such as cancer survivorship. Yet, little is known about how individuals make sense of somatic symptoms within uncertain health contexts, nor how this process guides health behaviors. Design: 25 adolescent and young adult survivors of childhood cancer completed semi-structured interviews regarding how they appraise and respond to changing somatic sensations within the uncertain context of survivorship. Main Outcome Measures: Interviews were transcribed verbatim and subjected to a hybrid deductive-inductive thematic analysis, guided by the Cancer Threat Interpretation model. Results: Theme 1 (‘symptoms as signals of bodily threat’) captured that participants commonly interpret everyday sensations as indicating cancer recurrence or new illness. Theme 2 (‘playing detective with bodily signals’) captured the cognitive and behavioral strategies that participants described using to determine whether somatic sensations indicated a health threat. These two themes are qualified by the recognition that post-cancer symptoms are wily and influenced by psychological factors such as anxiety (Theme 3: ‘living with symptom-related uncertainty’). Conclusions: These data highlight the need for novel symptom management approaches that target how somatic sensations are appraised and responded to as signals of bodily threat.<br/

Complacency and Bias in Human Use of Automation: An Attentional Integration

Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG geförderten) Allianz- bzw. Nationallizenz frei zugänglich.This publication is with permission of the rights owner freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.Objective: Our aim was to review empirical studies of complacency and bias in human interaction with automated and decision support systems and provide an integrated theoretical model for their explanation. Background: Automation-related complacency and automation bias have typically been considered separately and independently. Methods: Studies on complacency and automation bias were analyzed with respect to the cognitive processes involved. Results: Automation complacency occurs under conditions of multiple-task load, when manual tasks compete with the automated task for the operator’s attention. Automation complacency is found in both naive and expert participants and cannot be overcome with simple practice. Automation bias results in making both omission and commission errors when decision aids are imperfect.Automation bias occurs in both naive and expert participants, cannot be prevented by training or instructions, and can affect decision making in individuals as well as in teams.While automation bias has been conceived of as a special case of decision bias, our analysis suggests that it also depends on attentional processes similar to those involved in automation-related complacency. Conclusion: Complacency and automation bias represent different manifestations of overlapping automation-induced phenomena, with attention playing a central role. An integrated model of complacency and automation bias shows that they result from the dynamic interaction of personal, situational, and automation-related characteristics. Application: The integrated model and attentional synthesis provides a heuristic framework for further research on complacency and automation bias and design options for mitigating such effects in automated and decision support systems

How Nurses Balance Risk with Patient Autonomy When Making Decisions about Physical Restraint Use with Older Patients in Acute Care

The use of physical restraints to reduce falls within the older adult population in acute care hospital settings, are regarded as an integral part of risk management and prevention of patient harm (Bigwood & Crowe, 2008). Although literature indicates that nurses apply physical restraints to prevent injuries from a fall, there appears to be no robust evidence that links this intervention to injury prevention (Oliver, Healey, & Haines, 2010). Adding to this, decision-making around physical restraint use is a complex process and is influenced by different contextual factors (Dierckx de Casterle, Goethals, & Gastmans, 2015). The purpose of this interpretive descriptive study was to further understand how nurses balance risk with patient autonomy when making decisions about physical restraint use for falls prevention, and to provide a deeper understanding of risk and patient autonomy that are applicable and meaningful to everyday nursing practice. Perceptions related to nurses’ experience with balancing risk with patient autonomy were elicited through individual interviews with seven participants and one focus group session made up of five additional participants. The results of this research study provides insight into factors that influence the nurses’ decision-making process about whether or not to apply physical restraints