Understanding Patients' Decisions

摘要: Objective. —To describe ways in which intuitive thought processes and feelings may lead patients to make suboptimal medical decisions. Design. —Review of past studies from the psychology literature. Results. —Intuitive decision making is often appropriate results reasonable choices; some situations, however, intuitions choices that are not their best interests. People sometimes treat safety danger categorically, undervalue importance a partial risk reduction, influenced by way problem framed, inappropriately evaluate an action its subsequent outcome. These strategies help explain examples where perceptions conflict with standard scientific analyses. In domain emotions, people tend consider losses as more significant than corresponding gains, imperfect at predicting future preferences, distort memories personal experiences, have difficulty resolving inconsistencies between emotions rationality, worry intensity disproportionate actual danger. general, such intangible aspects clinical care received little attention Conclusion. —We suggest awareness how reason important skill can be promoted knowledge selected psychology. (JAMA. 1993;270:72-76)