M. Radhika Nath, Ph.D., University of Birmingham, Birmingham, United Kingdom
Purpose: Our understanding of people's conceptualisations regarding health states is limited at best. This research attempts to further our knowledge of how people configure different diseases mentally by uncovering the structure of individual mental models regarding common health conditions. Method: Thirty commonly recognizable health conditions were chosen for inclusion in the study. Health conditions were selected based on familiarity rankings by six judges. Data were collected using a cyclically deleted, incomplete design. Pairs of the thirty health conditions (265 in all) were presented to forty subjects who provided similarity judgments for the pairs. Multidimensional scaling was used to recreate maps of the conceptual disease space based on the similarity ratings provided by subjects. Data were analysed using PROXSCAL. A points-of-view analysis was carried out to determine if multiple models existed within the subject pool. The points-of-view analysis lead to the identification of two distinct sets of three-dimensional maps that best represented the similarities presented by the subjects. Results: The first point-of-view or three-dimensional map represented the similarity judgments of 33 subjects on 265 pairs of health conditions. The dimensions for this point-of-view were interpreted as Curable – Incurable, Physical – Neurological and Familiar – Unfamiliar based on similarity ratings. The second point-of-view encompassed the similarity judgments of 5 subjects on 265 pairs of health conditions. The dimensions for the second three-dimensional map were Adult – Children, Loss of functioning – Non-Loss of functioning and Fatal – Non-fatal. Conclusion: The results suggest that different and distinct conceptualizations of health states might exist in the population and that a universal model would not capture the richness of these diverse mental maps. Secondly, the study provides evidence that people conceptualize health states using multiple dimensions. There have been few attempts prior to this to understand individual conceptualizations of different health conditions. Understanding how people configure health states mentally offers insights into the way people think about and organize information about health states. It also promotes communication between the providers and users of medical services and to create better ways of eliciting patient preferences. At a more profound level it helps researchers and physicians understand the preferences people exhibit to questions involving different diseases.
See more of Oral Concurrent Session J - Measurement of Health Status and Preferences
See more of The 27th Annual Meeting of the Society for Medical Decision Making (October 21-24, 2005)