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

S. Zörgő (), G J Y. Peters, K. Csajbók-Veres, A. Geröly, A. Jeney and A R. Ruis
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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

Quality & Quantity: International Journal of Methodology, 2023, vol. 57, issue 4, No 8, 3105-3132

Abstract: 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.

Keywords: Complementary and alternative medicine; Decision-making; Push and pull factors; Lay etiology; Qualitative; Epistemic Network Analysis (search for similar items in EconPapers)
Date: 2023
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DOI: 10.1007/s11135-022-01496-5

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