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In animal care, when current decisions are made to maximise long-term quality of life (QoL), a key necessity is being able to make accurate predictions about how current choices will affect the animal's future QoL. However, in the procession of any individual's life, many factors that influence QoL change — some are foreseeable, many are not. Moreover, QoL has no fixed anchor points; it is dynamic, mutable, with a shifting frame of reference over time. In addition to actual changes in QoL over time, numerous factors have been identified that influence one's ability to adopt the mindset of the individual at a later point in time — for one's self as well as that of others. It has been shown that in people, across a wide range of health conditions, individuals with illness or disability typically report greater happiness and QoL than do healthy people envisioning themselves in similar circumstances (‘the disability paradox‘). Difficulties in QoL outcome prediction fall into two categories: (1) predictions made with the wrong mindset, in which there is a mismatch between the mindset of the assessor/predictor and that of the assessee/experiencer; and (2) predictions made on the basis of unforeseen or incorrectly estimated psychological changes in the assessee/experiencer.
Distrust of health care system or providers can affect a patient’s decisions concerning whether to seek medical care, how openly to share health concerns, and how closely to follow a provider’s advice. A person’s health literacy and understanding of disease can also shape their interactions with medical professionals. Some analyses of racial health disparities have considered how patient “preferences” and behavior might contribute to those disparities or provide a basis for doctors’ stereotypes of Black patients as “noncompliant.”1 Various initiatives have sought to increase the trust that Black people or those from other marginalized communities place in medicine, approaching patients’ low trust levels as if they were a vitamin deficiency that needed correcting.
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