An empirical investigation of practical reasoning in the construction of beliefs regarding medication by arthritis patients

Abstract

Patient drug consumption behavior has an impact on the outcomes, effectiveness, and costs associated with therapy. Patients' beliefs influence their health behaviors and little is known about how patients form beliefs. Therefore, an understanding of belief formation will assist professionals in developing interventions that effectively influence health behaviors. This study used the model of belief processing proposed by Smith, Benson, and Curley (1991) to examine the belief formation used by arthritis patients regarding their medication. Study subjects included arthritis patients from a health maintenance organization population. Forty-six subjects were randomly assigned to four groups. Three groups received different levels of information about a drug and were asked about their beliefs regarding its helpfulness. Subjects in the final group were asked about their beliefs regarding the helpfulness of nabumetone, a drug they were currently taking. Verbal protocols were independently coded by three coders using operational definitions from the literature and constructs in the model. The codes were tallied and the hypotheses were tested using ANOVA and MANOVA. Subjects used more practical reasoning than judgments or calculation to form their beliefs. Most subjects used responses that corresponded with two or more modules of the model. Contrary to expectations, providing more information did not influence the use of practical reasoning or judgments. Amount of information also did not influence subjects' use of most argument types. These findings suggest that (1) patients use practical reasoning rather than formal logical reasoning to form beliefs about the helpfulness of medications; (2) the "expectancy x value" approach is not appropriate in modeling the reasoning patients use to form beliefs about their medications; (3) the Smith, Benson, and Curley model contains constructs used by patients to form beliefs; (4) experience decreases the use of authoritative arguments in forming beliefs; and (5) increased information may influence beliefs, but it does not seem to influence the processing used to form beliefs.