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An epistemic network analysis of patient decision-making regarding choice of therapy

Author

Listed:
  • S. Zörgő

    (Semmelweis University)

  • G J Y. Peters

    (Open University)

  • K. Csajbók-Veres

    (Eötvös Loránd University)

  • A. Geröly

    (Eötvös Loránd University)

  • A. Jeney

    (Eötvös Loránd University)

  • A R. Ruis

    (University of Wisconsin−Madison)

Abstract

Patient decision-making concerning therapy choice has been thoroughly investigated in the Push/Pull framework: factors pushing the patient away from biomedicine and those pulling them towards Complementary and Alternative Medicine (CAM). Others have examined lay etiology as a potential factor in CAM use. We conducted semi-structured interviews with patients employing only biomedicine and those using CAM. The coded and segmented data was quantified and modelled using epistemic network analysis (ENA) to explore what effects push/pull factors and etiology had on the decision-making processes.There was a marked difference between our two subsamples concerning push factors: although both groups exhibited similar scaled relative code frequencies, the CAM network models were more interconnected, indicating that CAM users expressed dissatisfaction with a wider array of phenomena. Among pull factors, a preference for natural therapies accounted for differences between groups but did not retain a strong connection to rejecting conventional treatments. Etiology, particularly adherence to vitalism, was also a critical factor in both choice of therapy and rejection of biomedical treatments. Push factors had a crucial influence on decision-making, not as individual entities, but as a constellation of experienced phenomena. Belief in vitalism affects the patient’s explanatory model of illness, changing the interpretation of other etiological factors and illness itself. Scrutinizing individual push/pull factors or etiology does not explain therapeutic choices; it is from their interplay that decisions arise. Our unified, qualitative-andquantitative methodological approach offers novel insight into decision-making by displaying connections among codes within patient narratives.

Suggested Citation

  • S. Zörgő & G J Y. Peters & K. Csajbók-Veres & A. Geröly & A. Jeney & A R. Ruis, 2023. "An epistemic network analysis of patient decision-making regarding choice of therapy," Quality & Quantity: International Journal of Methodology, Springer, vol. 57(4), pages 3105-3132, August.
    • Handle: RePEc:spr:qualqt:v:57:y:2023:i:4:d:10.1007_s11135-022-01496-5
    DOI: 10.1007/s11135-022-01496-5
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    References listed on IDEAS

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    1. Connor, Linda H., 2004. "Relief, risk and renewal: mixed therapy regimens in an Australian suburb," Social Science & Medicine, Elsevier, vol. 59(8), pages 1695-1705, October.
    2. Michael S. Goldstein, 2002. "The Emerging Socioeconomic and Political Support for Alternative Medicine in the United States," The ANNALS of the American Academy of Political and Social Science, , vol. 583(1), pages 44-63, September.
    3. Heather Boon & Judith Belle Brown & Alan Gavin & Kathleen Westlake, 2003. "Men with Prostate Cancer: Making Decisions about Complementary/Alternative Medicine," Medical Decision Making, , vol. 23(6), pages 471-479, November.
    4. Sita Reddy, 2002. "Asian Medicine in America: The Ayurvedic Case," The ANNALS of the American Academy of Political and Social Science, , vol. 583(1), pages 97-121, September.
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