Information framing reduces initial negative attitudes in cancer patients’ decisions about hospice care Journal Article


Authors: Fridman, I.; Glare, P. A.; Stabler, S. M.; Epstein, A. S.; Wiesenthal, A.; Leblanc, T. W.; Higgins, E. T.
Article Title: Information framing reduces initial negative attitudes in cancer patients’ decisions about hospice care
Abstract: Background: Negative attitudes toward hospice care might prevent patients with cancer from discussing and choosing hospice as they approach end of life. When making a decision, people often naturally focus on either expected benefits or the avoidance of harm. Behavioral research has demonstrated that framing information in an incongruent manner with patients’ underlying motivational focus reduces their negative attitudes toward a disliked option. Objective: Our study tests this communication technique with cancer patients, aiming to reduce negative attitudes toward a potentially beneficial but often-disliked option, that is, hospice care. Methods: Patients (n = 42) with active cancer of different types and/or stages completed a paper survey. Participants read a vignette about a patient with advanced cancer and a limited prognosis. In the vignette, the physician's advice to enroll in a hospice program was randomized, creating a congruent message or an incongruent message with patients’ underlying motivational focus (e.g., a congruent message for someone most interested in benefits focuses on the benefits of hospice, whereas an incongruent message for this patient focuses on avoiding harm). Patients’ attitudes toward hospice were measured before and after receiving the physician's advice. Results: Regression analyses indicated that information framing significantly influenced patients with strong initial negative attitudes. Patients were more likely to reduce intensity of their initial negative attitude about hospice when receiving an incongruent message (b = −0.23; P < 0.01) than a congruent one (b = −0.13; P = 0.08). Conclusion: This finding suggests a new theory-driven approach to conversations with cancer patients who may harbor negative reactions toward hospice care. © 2018 American Academy of Hospice and Palliative Medicine
Keywords: palliative care; end-of-life care; decision making; advice; cancer; attitude change; information framing
Journal Title: Journal of Pain and Symptom Management
Volume: 55
Issue: 6
ISSN: 0885-3924
Publisher: Elsevier Inc.  
Date Published: 2018-06-01
Start Page: 1540
End Page: 1545
Language: English
DOI: 10.1016/j.jpainsymman.2018.02.010
PROVIDER: scopus
PUBMED: 29474940
PMCID: PMC8725201
DOI/URL:
Notes: Article -- Export Date: 1 June 2018 -- Source: Scopus
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  1. Andrew Saul Epstein
    157 Epstein
  2. Paul A Glare
    61 Glare
  3. Stacy Marie Stabler
    13 Stabler