Evidence map›Paper›PMID 39143039›Full record

ArticleJournal of the American Geriatrics Society2024

Older women's perspectives on the ethics of persuasion in doctor-patient communication.

Nancy L Schoenborn, Susan M Hannum, Sarah E Gollust, Rebekah H Nagler, Mara A Schonberg, Craig E Pollack, Cynthia M Boyd, Qian-Li Xue, Mary Catherine Beach

Abstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Nancy L SchoenbornDepartment of Medicine, Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.ORCID https://orcid.org/0000-0001-5053-5132
Susan M HannumDepartment of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
Sarah E GollustDivision of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA.
Rebekah H NaglerUniversity of Minnesota Hubbard School of Journalism and Mass Communication, Minneapolis, Minnesota, USA.
Mara A SchonbergBeth Israel Deaconess Medical Center, Harvard Medical School, Division of General Medicine and Primary Care, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0001-5162-5922
Craig E PollackDepartment of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
Cynthia M BoydDepartment of Medicine, Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Qian-Li XueDepartment of Medicine, Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Mary Catherine BeachDepartment of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Funding

Messaging Strategies to Reduce Breast Cancer Over-Screening in Older WomenR01AG066741 · NIA · JOHNS HOPKINS UNIVERSITY · PI SCHOENBORN, NANCY · 2021 to 2024
$2.3M
Patient-Centered Care for Older Adults with Multiple Chronic Conditions: Research and Mentoring ProgramK24AG056578 · NIA · JOHNS HOPKINS UNIVERSITY · PI BOYD, CYNTHIA MELINDA · 2017 to 2021
$1.1M
NIA NIH HHS K24 AG056578NIA NIH HHS K24AG056578NIA NIH HHS NIA R01AG066741-02S1NIA NIH HHS R01 AG066741
6 · The paper itself

Abstract

backgroundPublic health campaigns have often used persuasive techniques to promote healthy behaviors but the use of persuasion by doctors is controversial. We sought to examine older women's perspectives.

methodsWe conducted semi-structured interviews with 20 community-dwelling older women from the Baltimore metropolitan area. We asked whether participants thought it was ethically appropriate for doctors to try to persuade patients and explored their rationales. We probed about commonly used persuasive techniques and two example decisional contexts-stopping mammograms and moving out of one's house after multiple falls. We used qualitative thematic analysis to code the transcripts and summarized results into major themes.

resultsWe found mixed views on the ethical appropriateness of persuasion (theme 1); supporters of persuasion were motivated by the potential benefit to patients' health, whereas opponents thought patients should be the ultimate decision-makers. Perspectives depended on the persuasive technique (theme 2), where emotional appeals elicited the most negative reactions while use of facts and patient stories were viewed more positively. Perspectives also varied by the decisional context (theme 3), where higher severity and certainty of harm influenced participants to be more accepting of persuasion. Participants suggested alternative communication approaches to persuasion (theme 4) that emphasized respect for patients.

conclusionsOur findings suggest that the type of persuasive technique and the decisional context are important considerations in the ethical debate around the use of persuasion. Limiting the use of persuasion to high-stakes decisions and using facts and patient stories rather than emotional appeals are likely more acceptable.

Indexed as

Persuasive CommunicationPhysician-Patient RelationsAgedAged, 80 and overBaltimoreDecision MakingFemaleHealth PromotionHumansInterviews as TopicQualitative Researchdecision‐makingdoctor‐patient communicationethicspersuasion

Identifiers

PMID39143039
PMCPMC11461138

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.