Abstract: FR-PO008
How Education Affects Treatment Decision-Making: Novel Mechanistic Insights into Patients' Knowledge-Seeking and Psychological Changes
Session Information
- Classroom to Bedside: Transforming Medical Education
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Educational Research
- 1000 Educational Research
Authors
- Campbell-Montalvo, Rebecca, VA North Florida South Georgia Veterans Health System, Gainesville, Florida, United States
- Ftouni, Darin, VA North Florida South Georgia Veterans Health System, Gainesville, Florida, United States
- Shell, Popy, VA North Florida South Georgia Veterans Health System, Gainesville, Florida, United States
- Subhash, Shobha, VA North Florida South Georgia Veterans Health System, Gainesville, Florida, United States
- Pearce, Kailyn, VA North Florida South Georgia Veterans Health System, Gainesville, Florida, United States
- Shukla, Ashutosh M., VA North Florida South Georgia Veterans Health System, Gainesville, Florida, United States
Background
KRT-directed comprehensive pre-kidney failure education (CoPE) is a basic necessity to increase informed home dialysis use. Existing cognitive behavior theories and patient-level data suggest that CoPE may enhance knowledge, behavioral capacity, and self-efficacy to improve self-management and health outcomes. However, mechanistic effects of CoPE on these intermediate and patient outcomes have not been articulated.
Methods
To inform on these mechanistic effects, we draw on data from 42 of 511 Veterans participants of TEACH-VET, a randomized trial aimed to assess the effects of CoPE on a variety of outcomes including informed dialysis decision-making. These qualitative interviews were designed under Theoretical Domains Framework (TDF) – a metatheory involving a range of factors impacting health behavior and focused on participants’ perspectives on educational content of CoPE and treatment decisions about home dialysis (HoD). Interviews were thematically analyzed, grounded in the TDF as well as Cultural Model Theory. Key social-psychological mechanisms involved in decision making were elucidated through qualitative modeling.
Results
We found novel mechanistic insights into how people understand and think about illness and treatment in ways that motivate their decisions. Specifically, we found that CoPE impacted HoD selection by prompting participants to seek additional knowledge and spurring a range of psychological changes (Figure 1). These changes include new feelings of optimism about treatment, belief in one’s treatment capabilities, increased confidence in decision making, and feelings of security with care provided by the VA. Knowledge seeking and psychological changes ushered participants to plan for the future and make treatment decisions, supporting better management of CKD and kidney health outcomes.
Conclusion
This complex modeling identifies new aspects of how education impacts patient decision making which enhances our understanding and informs the design of patient education programs and informs future research.
Funding
- Veterans Affairs Support