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Decision-making Preferences (decision-making + preference)
Selected AbstractsThe role of doctor's opinion in shared decision making: what does shared decision making really mean when considering invasive medical procedures?,HEALTH EXPECTATIONS, Issue 2 2005Dennis J. Mazur MD Abstract Objective, The goal of this study was to gain understanding about patients' perspectives on decision making in the context of invasive medical interventions and whether patients' decision-making preferences influenced the type of information they desired to be provided by physicians. Design, Questionnaire study of consecutive patients in a university-based general medicine clinic. Interventions, Patients were presented with a randomized list of three types of information that physicians could provide (risk, benefit and physician's opinion on whether they should undergo the procedure). Patients were asked whether they preferred patient-based, physician-based, or shared decision making and then were asked to select which one or combination of these three information types was most important to them in their own decision making. Patients were also asked to self-report on how many invasive procedures they had undergone in their own lives. Participants, A total of 202 consecutive patients (mean age = 65.1 years, SD = 12.3, range 28,88; mean education 13.3 years, SD 2.9, range 2,23). Main outcome measures, Patient reports. Results, Of the 202 patients, two patients reported no decision-making preference. These two patients were excluded from the analysis. Of the 200 remaining patients, 62.5% (125/200) preferred shared, 22.5%(45/200) preferred physician-based, and 15.5% (31/200) preferred patient-based decision making. More than half of all subjects chose physician opinion as the most important type of information for decision making. Older patients (odds ratio 1.028; confidence interval 1.003,1.053) were more likely to have ranked the doctor's opinion as the most important in their decision making for invasive medical interventions. Conclusions, Although most patients want to share decision making with their physicians regarding invasive procedures, the majority of these patients report relying on the doctor's opinion on whether to undergo the procedure as the most important information in their own decision making. [source] Treatment decision-making and its relation to the sense of coherence and the meaning of the disease in a group of patients with colorectal cancerEUROPEAN JOURNAL OF CANCER CARE, Issue 3 2000E. Ramfelt The aims of the present study were to describe the preferred and the actual participating roles in treatment decision-making in relation to patients with newly diagnosed, colorectal cancer and to relate this result to the sociodemographic data, the Sense of Coherence Scale (SOC) and the patients' meaning of the disease. Eighty-six patients were studied. The following instruments were used: the Control Preferences Scale (CPS); the eight Lipowski categories of the meaning of the disease (LCMD); and the SOC. The results showed that 62% of the patients preferred a collaborative role and 28% a passive role in treatment decision-making. Agreement between the preferred and the actual participating roles was achieved by 44% of the patients. Seventy-one per cent of the patients showed an optimistic understanding of their disease. The mean SOC score was 150. There was no statistically significant difference between the CPS groups as regarded the sociodemographic data, the SOC and the LCMD. Conclusion: Sociodemographic data, the perceived meaning of the disease as well as the patients' sense of coherence were not related to the decision-making preferences in the investigated group of patients. Therefore, further investigations are needed to get an understanding of influencing factors of the decision-making preferences. [source] Differences in Oncologist Communication Across Age Groups and Contributions to Adjuvant Decision OutcomesJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2009Mary M. Step PhD The objective of this study was to assess potential age-related differences in oncologist communication during conversations about adjuvant therapy decisions and subsequent patient decision outcomes. Communication was observed between a cross-section of female patients aged 40 to 80 with early-stage breast cancer (n=180) and their oncologists (n=36) in 14 academic and community oncology practices in two states. Sources of data included audio recordings of visits, followed by post-visit patient interviews. Communication during the visit was assessed using the Siminoff Communication Content and Affect Program. Patient outcome measures included self-reported satisfaction with decision, decision conflict, and decision regret. Results showed that oncologists were significantly more fluent and more direct with older than middle-aged patients and trended toward expressing their own treatment preferences more with older patients. Satisfaction with treatment decisions was highest for women in their 50s and 60s. Decision conflict was significantly associated with more discussion of oncologist treatment preferences and prognosis. Decision regret was significantly associated with patient age and education. Older adults considering adjuvant therapy may find that oncologists' communication accommodations to perceived deficiencies in older adult cognition or communication challenge their decision-making involvement. Oncologists should carefully assess patient decision-making preferences and be mindful of accommodating their speech to age-related stereotypes. [source] Changing trends in the decision-making preferences of women with early breast cancer,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 3 2008L. J. M. Caldon Background: Previous studies have indicated a predominance of passive decision-making styles among women with early-stage breast cancer in the UK offered a choice between breast-conserving surgery (BCS) and mastectomy. The aim of this study was to determine current decision-making styles and establish their association with operation choice and breast unit mastectomy rate. Methods: A questionnaire survey was conducted among women from three specialist breast units representing high, medium and low case mix-adjusted mastectomy rates. Results: Of 697 consecutive patients, 356 (51·1 per cent) completed the questionnaire, a mean of 6·9 (range 1·3,48·6) weeks after surgery. Some 262 women (73·6 per cent) underwent BCS and 94 (26·4 per cent) had a mastectomy. Some 218 patients (61·2 per cent) achieved their preferred decision-making style. The proportions of women achieving an active decision-making style were high, particularly for those choosing mastectomy (83 versus 58·0 per cent for BCS; P < 0·001) and in the high mastectomy rate unit (79·6 versus 53 and 52·2 per cent for medium and low rate units respectively; P < 0·001). Conclusion: More women chose an active decision-making style than in previous UK studies. The provision of greater treatment selection autonomy to women suitable for BCS may not reduce mastectomy rates. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] | ||||||||||