The representation of risk in routine medical experience: what actions for contemporary health policy?

Abstract

Background: The comprehension of appropriate information about illnesses and treatments, can have beneficial effects on patients' satisfaction and on important health outcomes. However, it is questionable whether people are able to understand risk properly.

Aim: To describe patients' representation of risk in common medical experiences by linking such a representation to the concept of trust. A further goal was to test whether the representation of risk in the medical domain is associated to the level of expertise. The third goal was to verify whether socio-demographic differences influence the representation of risk.

Methods: Eighty voluntary participants from 6 health-centers in northern Italy were enrolled to conduct a semi-structured interview which included demographic questions, term-associations about risk representation, closed and open questions about attitudes and perception of risk in the medical context, as well as about medical expertise and trust.

Results: The results showed that people do not have in mind a scientific definition of risk in medicine. Risk is seen as a synonym for surgery and disease and it is often confused with fear. However, general knowledge of medical matters helps people to have a better health management through risk identification and risk information, adoption of careful behaviors and tendency to have a critical view about safety and medical news. Finally, trust proved to be an important variable in risk representation and risk and trust were correlated positively.

Conclusions: People must receive appropriate information about the risks and benefits of treatment, in a form that they can understand and apply to their own circumstances. Moreover, contemporary health policy should empower patients to adopt an active self-care attitude. Methodologies to enhance people's decision-making outcomes based on better risk communication should be improved in order to enable low literacy population as well elderly people to better understand their treatment and associated risk.

Figure 1. Diagnostic Box-Plot.

Figure 2. Word associations with the term “risk”.

Figure 3. Frequency histogram of the item “How much trust do you have in your GP”?

Figure 4. Frequency histogram of the item “Do you have a long-lasting and trustful relationship with your GP”?