Authors
- Rosario Caruso, Department of Biomedical Sciences for Health, University of Milan, 20122 Milan, Italy (ORCID: 0000-0002-7736-6209)
- Cristina Arrigoni, Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, 27100 Pavia, Italy
- Alice Silvia Brera, First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy (ORCID: 0000-0003-1107-768X); Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
DOI
https://doi.org/10.65241/wh.8.2.8
Article type:
Review
Abstract:
Background: Decision regret is a critical patient-centered outcome, particularly relevant for individuals with non-communicable diseases who face multiple therapeutic options with equivalent benefits. This study aimed to develop an integrated conceptual framework to clarify the determinants and pathways leading to decision regret and support patient-centered decision-making.
Methods: This study developed an integrated conceptual framework by combining a recent scoping review with bibliometric and lexicometric analyses. Titles, abstracts, and keywords from 28 full-text studies included in the scoping review were extracted and compiled into a RIS file. A preliminary lexicometric analysis quantified lexical diversity, while a keyword co-occurrence analysis was performed using VOSviewer to identify major thematic clusters. The findings were then integrated with a thematic synthesis to develop a comprehensive conceptual framework.
Results: The lexicometric analysis revealed a high degree of lexical diversity, as indicated by the Type-Token Ratio (0.7158) and Hapax Token Ratio (0.5736), suggesting thematic richness within the source data. Bibliometric mapping identified seven distinct conceptual clusters: psychological and emotional determinants, decision processes and patient involvement strategies, patient-reported outcomes and quality of life, attitudinal and motivational drivers, family-centered and developmental contexts, demographic characteristics, and analytical and context-specific factors. These clusters, synthesized with thematic findings, informed a structured conceptual framework that illustrates the relationships among predictors, mediators, and outcomes, all of which are modulated by an overarching cultural sphere.
Conclusions: The resulting framework offers a comprehensive and actionable model for understanding and potentially predicting decision regret among patients with non-communicable diseases. By integrating psychological, demographic, clinical, and contextual factors, it lays the foundation for developing tailored decision support interventions aimed at reducing regret and enhancing patient-centered care. Future empirical validation and application of this framework can inform personalized strategies to strengthen shared decision-making and improve patient outcomes.
Keywords:
Treatment-related distress, chronic conditions, supportive strategies, bibliometric analysis, shared decision-making, patient-centered care.