Patient decision-making personas: An application of a patient-centered cognitive task analysis (P-CTA)

Appl Ergon. 2020 Sep:87:103107. doi: 10.1016/j.apergo.2020.103107. Epub 2020 Apr 15.


Personas can be used to understand patterns of variation in patients' performance of cognitive work, particularly self-care decision making. In this study, we used a patient-centered cognitive task analysis (P-CTA) to develop self-care decision-making personas. We collected data from 24 older adults with chronic heart failure and 14 support persons, using critical incident and fictitious scenario interviews. Qualitative analyses produced three personas but revealed that individuals exemplify different personas across situations. The Rule-Following persona seeks clear rules, exercises caution under uncertainty, and grounds actions in confidence in clinician experts. The Researching persona seeks information to gain better understanding, invents strategies, and conducts experiments independently or with clinicians. The Disengaging persona does not actively seek rules or information and does not attempt to reduce uncertainty or conduct experiments. We discuss the situational nature of personas, their use in design, and the benefits of P-CTA for studying patient decision making.

Keywords: Chronic heart failure (CHF); Cognitive task analysis; Critical incident technique; Naturalistic decision making; Patient ergonomics and human factors; Personas; User-centered design.

MeSH terms

  • Aged
  • Chronic Disease
  • Cross-Sectional Studies
  • Decision Making*
  • Ergonomics*
  • Female
  • Health Behavior
  • Heart Failure / psychology*
  • Humans
  • Male
  • Patient-Centered Care
  • Prospective Studies
  • Self Care / psychology*
  • Task Performance and Analysis*