Complexity of Decision Making

In today’s world, the amount of information is overwhelming.  At the same time, we are constantly striving to practice DIY (do it yourself) medicine where we are reaching out to experts to help us sort thru information (especially when data is conflicting).  But, a lot of that assumes we know what we need or we know when to ask for help.

A study published recently in the Annals of Family Medicine looked a small group of diabetics and how they received information about their condition. 

They collected a nice long list of different sources used for information:

  • People
  • Physician
  • Nurse, nurse practitioner
  • Dietitian
  • Diabetes educator
  • Pharmacist
  • Dentist
  • Eye doctor, eye laser surgeon
  • Health care professional(s), specific role not indicated
  • Self, have had training as health professional or worked in medical field
  • Hospital-based diabetes center
  • Insurance company nurse, nurse, dietician, educator, wellness program personnel
  • Workplace nurse, health professional or wellness program
  • Family, including family members with diabetes
  • Friends, neighbors, coworkers, acquaintances, other patients, personal interaction, “word of mouth”
  • Classes or seminars
  • Support groups
  • Participation in research study
  • Comprehensive weight loss program
  • Health fair or similar event
  • Media
  • Internet (Web sites, search engines)
  • Information from organizations (eg, American Diabetes Association, American Kidney Foundation), other than from their Web sites
  • Books
  • Magazines (eg, Diabetes Forecast, Diabetes Self-Management, popular magazines—especially health/diet, cooking, women’s, African-American interest)
  • Television (eg, “D-Life,” news programs, talk shows, food-oriented shows)
  • Newspaper/newsmagazine articles
  • Booklets, brochures, etc, from clinic or health professionals
  • Booklets, brochures, newsletters, e-mail newsletters, etc, from miscellaneous sources (“in the mail”)
  • Information from pharmaceutical company, drugstore, medication supplier
  • Information from insurance company
  • Library
  • Bookstore
  • “Reading” or “studying” (type of material not specified)
  • “Media” or “articles” (not further specified)
  • Nutrition labels on food packages
  • Nutritional information pamphlet, fast foods
  • Product information (eg, Glucerna, information in insulin kit)
  • Atkins, South Beach diets
  • Reader’s Digest “Change One” program
  • Exercise videos
  • Printed reports of laboratory results

RESULTS Five themes emerged: (1) passive receipt of health information about diabetes is an important aspect of health information behavior; (2) patients weave their own information web depending on their disease trajectory; (3) patients’ personal relationships help them understand and use this information; (4) a relationship with a health care professional is needed to cope with complicated and sometimes conflicting information; and (5) health literacy makes a difference in patients’ ability to understand and use information.

CONCLUSIONS Patients make decisions about diabetes self-management depending on their current needs, seeking and incorporating diverse information sources not traditionally viewed as providing health information. Based on our findings, we have developed a new health information model that reflects both the nonlinear nature of health information-seeking behavior and the interplay of both active information seeking and passive receipt of information.

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