What Attitudes and Beliefs Underlie Patients' Decisions about Participating in Chemotherapy Trials?

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Abstract
The theory of reasoned action, which postulates that personal attitudes and external social influences predict intentions to undertake a behavior, was used as a conceptual framework for developing a questionnaire to elicit beliefs and attitudes associated with the decision to participate in a hypothetical cancer chemotherapy trial. After completing the questionnaire, two-thirds of the 150 respondents indicated they would enroll in such a trial if it were available. Considerable variation existed in both "universal" and "trial- specific" beliefs and attitudes underpinning their intentions. A substantial amount of the variance in "intention" to participate was explained by "attitude" alone (75%). So cial influences, although statistically significant, made a mere 1% additional contribu tion. One interpretation is that subjective expected-utility theory, which essentially pre dicts beliefs or "attitude," is a better model. The authors conclude that both theories may be criticized regarding how well they capture the rationality and nuances of de cision behavior. Key words: attitudes; beliefs; clinical trials; oncology. (Med Decis Mak ing 1998;18:61-69)