Distributed Cognition in Cancer Treatment Decision Making: An Application of the DECIDE Decision-Making Styles Typology

Janice L. Krieger, Jessica L. Krok-Schoen, Phokeng M. Dailey, Angela L. Palmer-Wackerly, Nancy Schoenberg, Electra D. Paskett, Mark Dignan

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Distributed cognition occurs when cognitive and affective schemas are shared between two or more people during interpersonal discussion. Although extant research focuses on distributed cognition in decision making between health care providers and patients, studies show that caregivers are also highly influential in the treatment decisions of patients. However, there are little empirical data describing how and when families exert influence. The current article addresses this gap by examining decisional support in the context of cancer randomized clinical trial (RCT) decision making. Data are drawn from in-depth interviews with rural, Appalachian cancer patients (N = 46). Analysis of transcript data yielded empirical support for four distinct models of health decision making. The implications of these findings for developing interventions to improve the quality of treatment decision making and overall well-being are discussed.

Original languageEnglish
Pages (from-to)1146-1159
Number of pages14
JournalQualitative Health Research
Issue number8
StatePublished - Jul 1 2017

Bibliographical note

Funding Information:
This work was supported by a grant from the National Cancer Institute (U54CA153604 UKY, PI: Dignan).

Publisher Copyright:
© SAGE Publications.


  • In-depth qualitative interviews
  • USA
  • cancer
  • communication
  • health disparities
  • region: Appalachia
  • treatment decision making

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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