Background.As patients become more involved in health care decisions, there may be greater opportunity for decision regret. The authors could not find a validated, reliable tool for measuring regret after health care decisions.Methods.A5- item scale was administered to 4 patient groups making different health care decisions. Convergent validity was deter- mined by examining the scale's correlation with satisfaction measures, decisional conflict, and health outcome measures.Results.The scale showed good internal consistency (Cronbach's = 0.81 to 0.92). It correlated strongly with decision satisfaction (r = -0.40 to -0.60), decisional conflict (r = 0.31 to 0.52), and overall rated quality of life (r = -0.25 to - 0.27). Groups differing on feelings about a decision also differed on rated regret: F(2, 190) = 31.1, P < 0.001. Regret was greater among those who changed their decisions than those who did not, t(175) = 16.11, P < 0.001.Conclusions.The scale is a useful indicator of health care decision regret at a given point in time.
Get full access to this article
View all access options for this article.
References
1.
1. O'Connor AM, Drake ER, Fiset V, Graham ID, Laupacis A, Tugwell P. The Ottawa patient decision aids . Eff Clin Pract. 1999;2: 163-170 .
2.
2. O'Connor AM, Rostom A, Fiset V, et al. Decision aids for patients facing health treatment or screening decisions: systematic review . Br Med J.1999;319: 731-734 .
3.
3. Hillis SD, Marchbanks PA, Tylor LR, Peterson HB. Poststerilization regret: findings from the United States Collaborative Review of Sterilization . Obstet Gynecol.1999;93: 889-895 .
4.
4. Clark JA, Wray N, Brody B, Ashton C, Giesler B, Watkins H. Dimensions of quality of life expressed by men treated for metastatic prostate cancer . Soc Sci Med.1997;45: 1299-1309 .
5.
5. Clark JA, Wray N, Brody B, Ashton C. Living with treatment decisions: regrets and quality of life among men treated for metastatic prostate cancer . J Clin Oncol.2001;19: 72-80 .
6.
6. Zeelenberg M, Beattie J. Consequences of regret aversion 2: additional evidence for effects of feedback on decision making . Org Behav Hum Decis Proc.1997;72: 63-78 .
7.
7. Guthrie C. Better settle than sorry: the regret aversion theory of litigation behavior . Univ Ill Law Rev.1999;1999: 43-90 .
8.
8. Richard R, van der Pligt J, de Vries N. Anticipated affective reactions and prevention of AIDS . Br J Soc Psychol. 1995;34: 9-21 .
9.
9. van Empelen P, Kok G, Jansen MWJ, Hoebe CJP. The additional value of anticipated regret and psychopathology in explaining in- tended condom use among drug users . AIDS Care. 2001;13: 309-318 .
10.
10. Creyer E, Ross W. The development and use of a regret experience measure to examine the effects of outcome feedback on regret and subsequent choice . Market Letts. 1999;10: 379-392 .
11.
11. Svenson O. Differentiation and consolidation theory of human decision making: a frame of reference for the study of pre- and post-decision processes . Acta Psychol.1992;80: 143-168 .
12.
12. Svenson O. Decision making and the search for fundamental psychological regularities: what can be learned from a process perspective? Org Behav Hum Decis Proc.1996;65: 252-267 .
13.
13. Gilovich T, Medvec VH. The experience of regret: what, when, and why . Psychol Rev.1995;102: 379-395 .
14.
14. Connolly T, Ordonez LD, Coughlan R. Regret and responsibility in the evaluation of decision outcomes . Org Behav Hum Decis Proc.1997;70: 73-85 .
15.
15. Zeelenberg M. The use of crying over spilled milk: a note on the rationality and functionality of regret . Philos Psychol.1999;12: 325-340 .
16.
16. Zeelenberg M, van Dijk WW, Manstead ASR. Reconsidering the relation between regret and responsibility . Org Behav Hum Decis Proc.1998;74: 254-272 .
17.
17. Hampshire S. Thought and Action. London: Chatto and Windus ; 1960.
18.
18. Landman J. Regret: Persistence of the Possible. New York: Oxford University Press ; 1993.
19.
19. Simonson I. The influence of anticipating regret and responsibility on purchasing decisions . J Consumer Res.1992;19: 105-118 .
20.
20. Zeelenberg M, van Dijk WW, van der Pligt J, Manstead ASR, van Empelen P, Reinderman D. Emotional reactions to the outcomes of decisions: the role of counterfactual thought in the experience of regret and disappointment . Org Behav Hum Decis Proc.1998;75: 117-141 .
21.
21. Zeelenberg M, van Dijk WW, Manstead ASR. Regret and responsibility resolved? Evaluating Ordonez and Connolly's (2000) conclusions . Org Behav Hum Decis Proc.2000;81: 143-154 .
22.
22. Connolly T, Zeelenberg M. Regret in decision making . Curr Direct Psychol Sci.2002;11: 212-216 .
23.
23. Sugden R. Regret, recrimination, and rationality . Theory Decis.1985;19: 135-160 .
24.
24. Bell D. Regret in decision making under uncertainty . Operations Res. 1982;30: 961-981 .
25.
25. Gilovich T, Medvec VH. The temporal pattern to the experience of regret . J Personal Soc Psychol.1994;67: 357-365 .
26.
26. Loomes G, Sugden R. Regret theory: an alternative theory of rational choice under uncertainty . Econ J.1982;92: 805-824 .
27.
27. Kahneman D, Tversky A. The psychology of preferences . Sci Am.1982;246: 160-173 .
28.
28. Miller D, Turnbull W, McFarland C. Counterfactual Thinking and Social Perception: Thinking about What Might Have Been. New York: Academic Press ; 1990. p. 305-331.
29.
29. Landman J. Regret: a theoretical and conceptual analysis . J Theory Soc Behav. 1987;17: 135-160 .
30.
30. Seta JJ, McElroy T, Seta CE. To do or not to do: desirability and consistency mediate judgements of regret . J Personal Soc Psychol.2001;80: 861-870 .
31.
31. Gleicher F, Kost K, Baker S, Strathman A, Richman S, Sherman S. The role of counterfactual thinking in judgements of affect . Personal Soc Psychol Bull.1990;16: 284-295 .
32.
32. Taylor K. A regret theory approach to assessing consumer satisfaction . Market Letts.1997;8: 229-238 .
33.
33. Tsiros M, Mittal V. Regret: a model of its antecedents and consequences in consumer decision marketing . J Consumer Res.2000;26: 401-417 .
34.
34. Inman J, Zeelenberg M. Regret in repeat purchase versus switching decisions: the attenuating role of decision justifiability . J Consumer Res.2002;29: 116-128 .
35.
35. Zeelenberg M, Pieters R. Comparing service delivery to what might have been. Behavioral responses to regret and disappointment . J Service Res.1999;2: 86-97 .
36.
36. Ramanathan M, Mishra US. Correlates of female sterilization regret in the southern states of India . J Biosoc Sci.2000;32: 547-558 .
37.
37. Platz-Christensen JJ, Tronstad SE, Johansson O, Carlsson SA. Evaluation of regret after tubal sterilization . Int J Gynaecol Obstet.1992;38: 223-226 .
38.
38. Marcil-Gratton N. Sterilization regret among women in metropolitan Montreal . Fam Plann Perspect.1988;20: 222-227 .
39.
39. Henshaw SK, Singh S. Sterilization regret among U.S. couples . Fam Plann Perspect.1986;18: 238-240 .
40.
40. Smith RD. Is regret theory and alternative basis for estimating the value of healthcare interventions? Health Pol.1996;37: 105-115 .
41.
41. Sawka C, Goel V, Mahut CA, et al. Development of a patient decision aid for choice of surgical treatment for breast cancer . Health Expect.1998;1: 23-36 .
42.
42. Siminoff LA, Ravdin R, Colabianchi N, Saunders Sturm CM. Doctor-patient communication patterns in breast cancer adjuvant therapy decisions . Health Expect.2000;3: 26-36 .
43.
43. Montgomery LL, Tran KN, Heelan MC, et al. Issues of regret in women with contralateral prophylactic mastectomies . Ann Surg Oncol.1999;6: 546-552 .
44.
44. O'Connor AM, Jacobsen M, Elmslie T, et al. Simple vs. complex patient decision aids: is more necessarily better? 16th Annual Meeting of the International Society of Technology Assessment in Health Care; 2000.
45.
45. Goel V, Sawka C, Thiel EC, Gort EH, O'Connor AM. Randomized trial of a patient decision aid for choice of surgical treatment for breast cancer . Med Decis Making. 2001;21: 1-6 .
46.
46. O'Connor AM. Validation of a decisional conflict scale . Med Decis Making. 1995;15: 25-30 .
47.
47. Gilovich T, Medvec VH. Some counterfactual determinants of satisfaction and regret. In: Roese N, Olson J, editors. What Might Have Been: The Social Psychology of Counterfactual Thinking. New York: Wiley ; 2003.
48.
48. Hetts J, Boninger D, Armor D, Gleicher F, Nathanson A. The influence of anticipated counterfactual regret on behavior . Psychol Market.2000;17: 345-368 .
49.
49. Slovic P, Lichtenstein S. Preference reversals: a broader perspective . Am Econ Rev.1983;73: 596-605 .
50.
50. Streiner D, Norman G. Health Measurement Scales: A Practical Guide to Their Development and Use. New York: Oxford University Press ; 1994.
51.
51. O'Connor AM, Tugwell P, Wells GA, et al. A decision aid for women considering hormone therapy after menopause: decision support framework and evaluation . Patient Educ Counsel.1998;33: 267-279 .
52.
52. Barry M, Cherkin J, Chang Y, Fowler F, Skates S. A randomized trial of a multimedia shared decision making programme for men facing a treatment decision for benign prostatic hyperplasia . Dis Manage Clin Outcomes.1997;1: 5-14 .
53.
53. Hilditch JR, Lewis J, Peter A, et al. A menopause-specific quality of life questionnaire: development and psychometric properties . Maturitas.1996;24: 161-175 .
54.
54. Strull WM, Lo B, Charles G. Do patients want to participate in medical decision making? JAMA.1984;252: 2990-2994 .
55.
55. Degner LF, Kristjanson LJ, Bowman D, et al. Information needs and decisional preferences in women with breast cancer . JAMA.1997;277: 1485-1492 .
56.
56. Aaronson NK, Ahmedzai S, Bergman B, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality- of-life instrument for use in international clinical trials in oncology . J Natl Cancer Inst.1993;85: 365-376 .
57.
57. Mellers B, Schwartz A, Ho K, Ritov I. Decision affect theory: emotional reactions to the outcomes of risky options . Psychol Sci.1997;8: 423-429 .
58.
58. Mellers B, Schwartz A, Ritov I. Emotion-based choice . J Exp Psychol: Gen.1999;128: 332-345 .
59.
59. Oliver R. Regret and hindsight: what might have been and what I knew would be. In: Satisfaction: A Behavioural Perspective on the Consumer. New York: McGraw-Hill ; 1997. p. 216-236.
60.
60. Svenson O, Malmsten N. Post-decision consolidation over time as a function of gain or loss of an alternative . Scand J Psychol.1996;37: 302-311 .
61.
61. Brickman P, Coates D, Janoff-Bulman R. Lottery winners and accidents victims: is happiness relative? J Personal Soc Psychol.1978;36: 917-927 .
62.
62. Asch S. Forming impressions of personality . J Abnorm Soc Psychol.1946;41: 258-290 .
63.
63. Nisbett R, Wilson T. The halo effect: evidence for unconscious alteration of judgments . J Personal Soc Psychol.1977;35: 250-256 .
