An outcomes model of medical decision making

In the traditional fix-it model of medical decision making, the identified problem is typically characterized by a diagnosis that indicates a deviation from normalcy. When a medical problem is multifaceted and the available interventions are only partially effective, a broader vision of the health care endeavor is needed. What matters to the patient, and what should matter to the practitioner, is the patient's future possibilities. More specifically, what is important is the character of the alternative futures that the patient could have and choosing among them so as to achieve the best future possible, with the ranking of outcomes determined by the patient's preferences. This paper describes the fix-it model, presents and defends the outcomes-based model, and demonstrates that the latter is useful in developing normative conceptions of informed consent and decision making and in establishing a basis for societal involvement in the decision making process. Finally, several shortcomings of the model will be acknowledged.     

A client‐generated psychometric instrument: The development of ‘PSYCHLOPS’

PSYCHLOPS (Psychological Outcome Profiles) is a recently developed, client‐generated, psychometric instrument that can be used as an outcome measure. Based on a similar instrument developed primarily for use in physical illnesses (MYMOP — ‘Measure Your Medical Outcome Profile’), it seeks the client's perspective on their psychological distress. It asks them to describe and then score the problem that troubles them the most at the start of counselling. We describe the development of PSYCHLOPS, including the involvement of the Plain English Campaign and two national mental health organisations: the mental health charity and support group, Depression Alliance (DA) and Primary Care Mental Health Education (PRIMHE). We review the literature and suggest that PSYCHLOPS, by focusing on the problems of greatest priority to the client, might prove a sensitive measure of improvement after counselling.     

The effects of college major and job field congruence on job satisfaction

This study investigated predictors of job satisfaction and builds on previous research on the effects of bachelor’s degree majors and job field congruence on job satisfaction. Data on workers’ job experiences in 2001 were matched to those workers’ college experiences across 30 institutions and background characteristics up to 25 years earlier. With statistical controls for demographic, socioeconomic, and academic characteristics, a final sample of 2515 college graduates was used to test hypotheses centered on the possibility that a causal order relates education and job satisfaction. Specifically, college degree majors, measures of both actual and perceived congruence, as well as income were examined in relation to three dimensions of job satisfaction. Results support hypotheses that income and congruence both mediate the effects of majors on job satisfaction, and identify that two different measures of congruence are causally related to intrinsic dimensions of job satisfaction.     

Predicting the intensity of losses vs. non-gains and non-losses vs. gains in judging fairness and value: A test of the loss aversion explanation

Three studies examined the predictions that in the context of evaluation of fairness and concessions in negotiations, losses would be perceived as more intensely negative than non-gains, and that non-losses would be perceived as more positive than gains. Extant studies tested only the first of these predictions. These predictions derive from the principle of loss aversion (LA), according to which losses are experienced more intensely than gains of similar objective magnitude. In this view, losses and non-losses are measured against the steep loss part of the value curve, whereas gains and non-gains are measured against the shallow part of the value curve. Our studies replicated extant studies in confirming the first prediction but failed to confirm the second prediction. Specifically, opposite to the prediction of LA, gains were perceived as more intensely positive than non-losses. It seems, therefore, that LA is not a sufficient explanation of why losses are perceived as more averse than gains. Feature positive and regulatory focus effects are discussed as additional potential contributors to the phenomenon.     

Contingent approaches to making likelihood judgments about polychotomous cases: the influence of task factors

Two experiments tested the influence of three task factors on respondents' tendency to use normative, heuristic, and random approaches to making likelihood judgments about polychotomous cases (i.e., cases in which there is more than one alternative to a focal hypothesis). Participants estimated their likelihood of winning hypothetical raffles in which they and other players held various numbers of tickets. Responding on non‐numeric scales (vs. numeric ones) and responding under time pressure (vs. self‐paced) increased participants' use of a comparison‐heuristic approach, resulting in non‐normative judgment patterns. A manipulation of evidence representation (whether ticket quantities were represented by numbers or more graphically by bars) did not have reliably detectable effects on processing approaches to likelihood judgment. The authors discuss the implications of these findings for the further development of likelihood judgment theories, and they discuss parallels between contingent processing in choice and contingent processing in likelihood judgment. Copyright © 2005 John Wiley & Sons, Ltd.     

Effects of consumer perceptions of brand experience on the web: brand familiarity,satisfaction and brand trust

Creating a customer experience that is synonymous with a particular (website) brand is becoming increasingly recognised as a vital driver of e‐performance. E‐tailors are just as likely to try to influence consumers' shopping behaviour, through atmospherics and service, as brick‐and‐mortar stores. This study investigates several questions that have been left unanswered in recent studies of consumer behaviour in the context of internet‐based marketing. Its focus lies in addressing the issue of whether there is a direct relationship between brand experience and brand trust or whether there is an indirect relationship via satisfaction or brand familiarity. The results of an empirical study of e‐consumer behaviour show that brand trust is achieved through the following dimensions operating and interrelating as antecedent constructs: first, various brand experiences and the search for information, secondly, a high level of brand familiarity, and thirdly, customer satisfaction based on cognitive and emotional factors. These findings should assist marketers and academics in their understanding of the development of brand trust in an internet‐based environment. Copyright © 2005 John Wiley & Sons, Ltd.     

心理会计与推理选择研究的新进展

心理会计与推理选择是行为决策理论的两个重要领域,本文主要综述它们在消费者偏好建构中的作用。研究表明,心理会计的原则常常调节对奢侈品的购买与消费;在这一调节过程中,推理可能发挥重要作用。本文还评述,在建构消费偏好的过程中,消费者有时选择最充分的理由,而不是选择最佳的选项;在其它一些情况下,消费者聚焦理由可能导致购买决策与消费体验之间的矛盾,以及偏好的非传递性。     

Learning Disabilities and Emotional Intelligence

The literature is conflicted around the subject of the emotional abilities of individuals with Specific Learning Disabilities (SLDs): While many claim cognitive challenges are associated with emotional difficulties, some suggest emotional and interpersonal abilities are not compromised in such disorders and may help individuals compensate and cope effectively with the challenges they meet in learning environments. Two studies explored differences in emotional intelligence (EI) between young adults with and without SLD. Two samples (matched on gender, approximate age, and program of study; n = 100, and unmatched; n = 584) of college students took self-report and performance-based tests of EI (Ability-EI) as well as a measure of self-esteem and demographics associated with college performance (e.g.: SAT scores, gender, etc.). The results showed that while SAT scores and ability emotional intelligence (Ability-EI) were associated with college GPA, Ability-EI did not differ between the two groups, while self-report measures of EI and self-esteem did show differences, with the group with learning disabilities ranking lower. The effects remained stable when we controlled for demographics and potential intervening factors. The results suggest that EI may play a protective role in the association between background variables and college attainment in students with SLD. The results may provide a basis for interventions to empower students with SLD in academia.     

Healthcare at Your Fingertips: The Professional Ethics of Smartphone Health-Monitoring Applications

Health professionals are inundated by the surfeit of health apps while lacking guidance to help them critically evaluate whether a particular health-monitoring app is safe, likely to lead to clinical benefit, and not introduce additional liability. Our objective is not to argue for or against the use of mobile health-monitoring apps but to illuminate the associated ethical issues and provide recommendations to guide the ethical decision-making process for clinicians who are considering the use of a mobile health-monitoring app. To this end, the Canadian Code of Ethics for Psychologists is used as a framework to situate recommendations.