Assessing the predictive power of psychological empowerment and health literacy for older patients’ participation in health care: a cross-sectional population-based study

Abstract Background Research has confirmed a positive link between patient involvement in decision-making and improvements in health outcomes. The objective of this study was to examine the roles of psychological empowerment and health literacy on the elderly’s willingness to engage in treatment decisions. Methods A self-administered questionnaire was completed by a randomly selected sample of Swiss adults aged 65–80 years old (N = 826). Multivariate logistic regression was applied to determine the contribution of health literacy, psychological empowerment, and trust in physician on participants’ preference to be active, collaborative or passive in decision-making. Results Most of the survey respondents preferred some participation in dealing with health related decisions (collaborative: 51%, and active: 35.6%). More than two-thirds of the sample was satisfied with their current involvement in medical decision-making (72.7%). Roughly one-fifth (18.8%) wished to attain a more active engagement than currently experienced, and the remainder of the sample preferred the opposite (8.5%). Due to higher reported levels of psychological empowerment and health literacy, Swiss-German seniors significantly preferred and assumed higher participation in medical decisions than Swiss-Italians. Psychological empowerment correlated with older adults’ preferred and perceived involvement in medical decision-making. However, health literacy only predicted actual involvement in the last treatment decision that had to be made, differentiating only the active from the passive involvement group. Additionally, this research showed that health literacy mediated the relationship between psychological empowerment and the actual involvement in the last treatment decision that had to be made by the participant. Trust in physician and age appeared to be barriers to involvement, whereas education served as a facilitator. Conclusions As older adults’ health literacy plays a role in individuals’ willingness to attain an active role in health care decision-making, public health efforts should aim at developing programs and appropriate information that facilitate this process, especially for individuals with moderate or lower levels of health literacy. The current investigation showed that adequate health literacy levels are essential (but not sufficient) in order to reach higher rates of participation in the healthcare context. This research complements past evidence by adding knowledge on the psychosocial antecedents, and their combined effects on patients’ involvement in healthcare

Consumer decision-making based on review websites: are there differences between choosing a hotel and choosing a physician?

Background: Web users are increasingly encouraged to rate and review consumer services (eg, hotels, restaurants) and, more recently, this is also the case for physicians and medical services. The resemblance in the setup and design of commercial rating websites (CRWs) and Web-based physician rating websites (PRWs) raises the question of whether choice-making processes based on the two types of websites could also be similar. Objective: This qualitative study sought to explore the extent to which consumer decision making based on Web-based reviews is the same for consumer services (ie, choice of a hotel) and health services (ie, choice of a pediatrician), while providing an in-depth understanding of potential differences or similarities. Methods: Between June and August 2015, we carried out a total of 22 qualitative interviews with young parents residing in the German-speaking part of Switzerland. Participants were invited to complete 2 choice tasks, which involved (1) choosing a hotel based on the commercial Web-based rating website TripAdvisor and (2) selecting a pediatrician based on the PRW Jameda. To better understand consumers’ thought processes, we instructed participants to “think aloud”, namely to verbalize their thinking while sorting through information and reaching decisions. Using a semistructured interview guide, we subsequently posed open-ended questions to allow them to elaborate more on factors influencing their decision making, level of confidence in their final choice, and perceived differences and similarities in their search for a hotel and a physician. All interviews were recorded, transcribed, and analyzed using an inductive thematic approach. Results: Participants spent on average 9:57 minutes (standard deviation=9:22, minimum=3:46, maximum=22:25) searching for a hotel and 6:17 minutes (standard deviation=4:47, minimum=00:38, maximum=19:25) searching for a pediatrician. Although the choice of a pediatrician was perceived as more important than the choice of a hotel, participants found choosing a physician much easier than selecting an appropriate accommodation. Four main themes emerged from the analysis of our interview data that can explain the differences in search time and choice confidence: (1) trial and error, (2) trust, (3) competence assessment, and (4) affect and likeability. Conclusions: Our results suggest that, despite congruent website designs, individuals only trust review information to choose a hotel, but refuse to fully rely on it for selecting a physician. The design and content of Web-based PRWs need to be adjusted to better address the differing information needs of health consumers

Wen erreicht man wodurch wie gut? Die Rolle von Konsequenzframing und formaler Bildung bei der Kommunikation der Folgen von Bewegungsmangel

Wagner A, Sukalla F. Wen erreicht man wodurch wie gut? Die Rolle von Konsequenzframing und formaler Bildung bei der Kommunikation der Folgen von Bewegungsmangel. In: Camerini A-L, Ludolph R, Rothenfluh F, eds. Gesundheitskommunikation im Spannungsfeld zwischen Theorie und Praxis. Medien + Gesundheit. Vol 13. Baden-Baden: Nomos; 2016: 113-124

Die mediale Diskussion zu medizinischen und ethischen Aspekten des pharmakologischen Neuroenhancements

Quiring O, Reifegerste D, Schäfer M. Die mediale Diskussion zu medizinischen und ethischen Aspekten des pharmakologischen Neuroenhancements. In: Camerini A-L, Ludolph R, Rothenfluh F, eds. Gesundheitskommunikation im Spannungsfeld zwischen Theorie und Praxis. Gesundheitskommunikation/ Health Communication. Vol 13. Baden-Baden: Nomos Verlagsgesellschaft mbH & Co. KG; 2016: 42-52

Zielgruppenspezifische Gesundheitskommunikation für Männer-Apps als Praxisoption

Klenk S, Reifegerste D, Renatus R. Zielgruppenspezifische Gesundheitskommunikation für Männer-Apps als Praxisoption. In: Camerini A-L, Ludolph R, Rothenfluh F, eds. Gesundheitskommunikation im Spannungsfeld zwischen Theorie und Praxis. Gesundheitskommunikation/Health Communication. Vol Band, 13. 1. Aufl. Baden-Baden: Nomos Verlagsgesellschaft mbH & Co. KG; 2016: 286-297

Bewegt durch Bilder? Der Einfluss von Aufmerksamkeit und Hintergrundmotiv

Guenther L, Kessler SH, Reifegerste D. Bewegt durch Bilder? Der Einfluss von Aufmerksamkeit und Hintergrundmotiv. In: Camerini A-L, Ludolph R, Rothenfluh F, eds. Gesundheitskommunikation im Spannungsfeld zwischen Theorie und Praxis. Gesundheitskommunikation/ Health Communication. Vol 13. 1. Aufl. Baden-Baden: Nomos Verlagsgesellschaft mbH & Co. KG; 2016: 131-141