Why is Housing Always Satisfactory? A Study into the Impact of Preference and Experience on Housing Appreciation.

This study focuses on residents' perceptions of residential quality concerning 23 different dwelling aspects. Respondents were asked to indicate their appreciation of these dwelling aspects on a scale ranging from 0 ("extremely unattractive") to 100 ("extremely attractive"). The influence of two potential factors on the appreciation of dwelling aspects is examined: (1) preference and (2) experience. It was hypothesized that residents who live according to their preferences give higher appreciation scores than residents who do not. This should even apply to low-quality housing. Furthermore, it was argued that residents appreciate their current housing situation more than residents who do not live in that particular housing situation. This effect should be independent of preference. The impact of both preference and of experience could be confirmed. The results also showed an interaction effect between preference and experience: the positive effect of experience on appreciation is larger in residents who live in a housing situation that they do not prefer. This result would be expected if the impact of experience works to decrease the 'gap' in residential satisfaction due to the discrepancy between what residents have and what they want. In conclusion, why is housing always satisfactory? In this paper, housing is satisfactory because the 'gap' between what residents want and what they have is small; residents seem to have realistic aspirations. Furthermore, residents appreciate what they already have, even if this is not what they prefer.

Factors affecting patients' perceptions of choice regarding adjuvant chemotherapy for breast cancer.

INTRODUCTION: Patients' perceptions of having had freedom of choice in treatment decision-making are shown to have implications for their quality of life. It is, therefore, important to determine what factors underlie these perceptions. One factor that has been studied is whether or not patients believed that their doctor had offered choice of treatment. However, even when choice is actually offered, patients may still feel that they have no choice. Little attention has been paid to other factors that may contribute to patients' perceptions of having had no choice. Our purpose was to explore (1) whether early-stage breast cancer patients perceived to have had a choice with regard to adjuvant chemotherapy, and (2) their reasons for having perceived no choice. PATIENTS AND METHODS: The determinants of no choice that we examined were: (1) (preferred) involvement in treatment decision-making, (2) perceived clinical benefits of chemotherapy (e.g., cure), (3) perceived psychological benefits (e.g., less worries), and (4) perception of being able to cope with the side effects. All predictors, as well as patient and clinical characteristics, were entered simultaneously in a multiple logistic regression analysis and non-significant predictors were removed step-by-step, until only significant predictors (p<0.05) remained. Because determinants may differ between patients with experience of chemotherapy and those without, both treatment groups were analyzed separately. RESULTS: Four hundred and forty-six patients filled out the questionnaire (62%). Sixty-six percent of patients who had been treated with chemotherapy and 86% of inexperienced patients had perceived no treatment choice. In both treatment groups, patients who preferred a shared role or a passive role in treatment decision-making were statistically significantly more likely to have perceived no treatment choice than patients who preferred an active role. Surprisingly, beliefs about the clinical and psychological benefits of chemotherapy did not influence patients' perceptions of having had choice of treatment. CONCLUSION: If we adhere to patient autonomy and shared decision making, we may consider the perception of no treatment choice as a negative outcome of treatment decision-making. However, if this is the result of the patients' preference for less active involvement in treatment decision-making, the topic of perception of no treatment choice may be viewed in a different light.

Review of determinants of patients' preferences for adjuvant therapy in cancer.

PURPOSE: Many studies have determined cancer patients' preferences for adjuvant therapy, for example, by asking patients the extent of benefit they would need in order to accept the therapy. However, little is known about the determinants that influence these preferences. Our research goal was to explore which determinants underlie patients' preferences by means of a literature review. METHODS: PubMed searches were conducted to identify studies in which cancer patients' preferences for adjuvant therapy had been elicited by means of a treatment preference instrument. Twenty-three papers were evaluated with regard to reported relationships between preferences and potential determinants. A total of 40 determinants were recorded and classified into one of seven categories: (1) treatment-related determinants, (2) sociodemographic characteristics and current quality of life, (3) clinical characteristics, (4) measurement instrument-related determinants, (5) time-related determinants, (6) cognitive/affective determinants, and (7) specialist-related determinants. RESULTS: The benefit and toxicity of treatment, experience of the treatment, and having dependents (eg, children) living at home were important determinants of patients' preferences. Furthermore, qualitative data suggested that cognitive/affective and specialist-related determinants might have a large impact on patients' treatment preferences. CONCLUSION: Our results show that patients' preferences cannot fully be explained on the basis of treatment-related determinants and patient and clinical characteristics. More research is needed in the area of cognitive/affective and specialist-related determinants because of the lack of quantitative results. Furthermore, we recommend carrying out larger studies in which the (internal) relationships between determinants and preferences are assessed in the context of a cognitive cost-benefit model.