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      Patient Preference and Adherence (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on the growing importance of patient preference and adherence throughout the therapeutic process. Sign up for email alerts here.

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      What are judgment skills in health literacy? A psycho-cognitive perspective of judgment and decision-making research

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          Abstract

          Objective

          The aim of this review is to summarize current research relating to psychological processes involved in judgment and decision-making (JDM) and identify which processes can be incorporated and used in the construct of health literacy (HL) in order to enrich its conceptualization and to provide more information about people’s preferences.

          Methods

          The literature review was aimed at identifying comprehensive research in the field; therefore appropriate databases were searched for English language articles dated from 1998 to 2015.

          Results

          Several psychological processes have been found to be constituents of JDM and potentially incorporated in the definition of HL: cognition, self-regulation, emotion, reasoning-thinking, and social perception.

          Conclusion

          HL research can benefit from this JDM literature overview, first, by elaborating on the idea that judgment is multidimensional and constituted by several specific processes, and second, by using the results to implement the definition of “judgment skills”. Moreover, this review can favor the development of new instruments that can measure HL.

          Practical implications

          Future researchers in HL should work together with researchers in psychological sciences not only to investigate the processes behind JDM in-depth but also to create effective opportunities to improve HL in all patients, to promote good decisions, and orient patients’ preferences in all health contexts.

          Most cited references75

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          Trust and sources of health information: the impact of the Internet and its implications for health care providers: findings from the first Health Information National Trends Survey.

          The context in which patients consume health information has changed dramatically with diffusion of the Internet, advances in telemedicine, and changes in media health coverage. The objective of this study was to provide nationally representative estimates for health-related uses of the Internet, level of trust in health information sources, and preferences for cancer information sources. Data from the Health Information National Trends Survey were used. A total of 6369 persons 18 years or older were studied. The main outcome measures were online health activities, levels of trust, and source preference. Analyses indicated that 63.0% (95% confidence interval [CI], 61.7%-64.3%) of the US adult population in 2003 reported ever going online, with 63.7% (95% CI, 61.7%-65.8%) of the online population having looked for health information for themselves or others at least once in the previous 12 months. Despite newly available communication channels, physicians remained the most highly trusted information source to patients, with 62.4% (95% CI, 60.8%-64.0%) of adults expressing a lot of trust in their physicians. When asked where they preferred going for specific health information, 49.5% (95% CI, 48.1%-50.8%) reported wanting to go to their physicians first. When asked where they actually went, 48.6% (95% CI, 46.1%-51.0%) reported going online first, with only 10.9% (95% CI, 9.5%-12.3%) going to their physicians first. The Health Information National Trends Survey data portray a tectonic shift in the ways in which patients consume health and medical information, with more patients looking for information online before talking with their physicians.
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            Comparison processes in social judgment: mechanisms and consequences.

            This article proposes an informational perspective on comparison consequences in social judgment. It is argued that to understand the variable consequences of comparison, one has to examine what target knowledge is activated during the comparison process. These informational underpinnings are conceptualized in a selective accessibility model that distinguishes 2 fundamental comparison processes. Similarity testing selectively makes accessible knowledge indicating target-standard similarity, whereas dissimilarity testing selectively makes accessible knowledge indicating target-standard dissimilarity. These respective subsets of target knowledge build the basis for subsequent target evaluations, so that similarity testing typically leads to assimilation whereas dissimilarity testing typically leads to contrast. The model is proposed as a unifying conceptual framework that integrates diverse findings on comparison consequences in social judgment.
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              The role of emotion in decision-making: evidence from neurological patients with orbitofrontal damage.

              Most theories of choice assume that decisions derive from an assessment of the future outcomes of various options and alternatives through some type of cost-benefit analyses. The influence of emotions on decision-making is largely ignored. The studies of decision-making in neurological patients who can no longer process emotional information normally suggest that people make judgments not only by evaluating the consequences and their probability of occurring, but also and even sometimes primarily at a gut or emotional level. Lesions of the ventromedial (which includes the orbitofrontal) sector of the prefrontal cortex interfere with the normal processing of "somatic" or emotional signals, while sparing most basic cognitive functions. Such damage leads to impairments in the decision-making process, which seriously compromise the quality of decisions in daily life. The aim of this paper is to review evidence in support of "The Somatic Marker Hypothesis," which provides a systems-level neuroanatomical and cognitive framework for decision-making and suggests that the process of decision-making depends in many important ways on neural substrates that regulate homeostasis, emotion, and feeling. The implications of this theoretical framework for the normal and abnormal development of the orbitofrontal cortex are also discussed.
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                Author and article information

                Journal
                Patient Prefer Adherence
                Patient Prefer Adherence
                Patient Preference and Adherence
                Patient preference and adherence
                Dove Medical Press
                1177-889X
                2015
                23 November 2015
                : 9
                : 1677-1686
                Affiliations
                [1 ]Department of Health Sciences, Faculty of Medicine, University of Milan, Milan, Italy
                [2 ]Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
                [3 ]Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy
                Author notes
                Correspondence: Silvia Riva, Department of Health Sciences, Faculty of Medicine, University of Milan, Via A Di Rudinì 8, 20142 Milan, Italy, Tel +39 02 5032 1240, Email silvia.riva1@ 123456unimi.it
                Article
                ppa-9-1677
                10.2147/PPA.S90207
                4664540
                2bd5967c-c931-45ab-9aa2-91a5c2053a84
                © 2015 Riva et al.. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License

                The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                History
                Categories
                Review

                Medicine
                health literacy,judgment,decision-making,psychological processes,skills,cognitive factors
                Medicine
                health literacy, judgment, decision-making, psychological processes, skills, cognitive factors

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