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首页> 美国卫生研究院文献>Journal of General Internal Medicine >Using Insights From Behavioral Economics and Social Psychology to Help Patients Manage Chronic Diseases
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Using Insights From Behavioral Economics and Social Psychology to Help Patients Manage Chronic Diseases

机译：利用行为经济学和社会心理学的见解来帮助患者管理慢性病

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Despite a revolution in therapeutics, the ability to control chronic diseases remains elusive. We present here a conceptual model of the potential role of behavioral tools in chronic disease control. Clinicians implicitly accept the assumption that patients will act rationally to maximize their self-interest. However, patients may not always be the rational actors that we imagine. Major behavioral barriers to optimal health behavior include patients’ fear of threats to health, unwillingness to think about problems when risks are known or data are ambiguous, the discounting of risks that are far in the future, failure to act due to lack of motivation, insufficient confidence in the ability to overcome a health problem, and inattention due to pressures of everyday life. Financial incentives can stimulate initiation of health-promoting behaviors by reducing or eliminating financial barriers, but may not produce long-term behavior change without additional interventions. Strategies have been developed by behavioral economists and social psychologists to address each of these barriers to better decision-making. These include: labeling positive behaviors in ways consistent with patient life goals and priorities; greater focus on more immediate risks of chronic diseases; intermediate subgoals as steps to a large health goal; and implementation of specific plans as to when, where, and how an action will be taken. Such strategies hold promise for improving health behaviors and disease control, but most have not been studied in medical settings. The effectiveness of these approaches should be evaluated for their potential as tools for the clinician.
机译：尽管治疗方法发生了革命，但控制慢性病的能力仍然难以捉摸。我们在这里提出了行为工具在慢性病控制中潜在作用的概念模型。临床医生隐含地接受这样的假设，即患者将采取合理的行动以最大化自身利益。但是，患者可能并不总是我们所想象的理性行为者。最佳健康行为的主要行为障碍包括患者对健康威胁的恐惧，在已知风险或数据模棱两可时不愿考虑问题，将来风险遥不可及，由于缺乏动力而无法采取行动，对克服健康问题的能力缺乏信心，以及由于日常生活压力而引起的注意力不集中。财务激励措施可以通过减少或消除财务障碍来刺激健康促进行为的发起，但是如果没有其他干预措施，可能不会产生长期的行为改变。行为经济学家和社会心理学家已经制定了解决这些障碍的策略，以更好地制定决策。这些措施包括：以符合患者生活目标和重点的方式标记积极行为；更加关注慢性病的更直接风险；中间的子目标，作为实现大型健康目标的步骤；关于何时，何地以及如何采取行动的具体计划的实施。这种策略有望改善健康行为和疾病控制，但大多数尚未在医学环境中进行研究。应该评估这些方法的有效性，以作为临床医生的工具。

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