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Decisional conflict

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https://www.readbyqxmd.com/read/29150522/addressing-decisional-conflict-about-fertility-preservation-helping-young-female-cancer-survivors-family-planning-decisions
#1
Madleina Müller, Corinne Urech, Jacky Boivin, Verena Ehrbar, Rebecca Moffat, Rosanna Zanetti Daellenbach, Christoph Rochlitz, Sibil Tschudin
BACKGROUND: Health professionals are challenged by a growing number of young long-term cancer survivors with their specific needs with regard to family planning. This study aimed at assessing decisional conflict (DC) in young female cancer patients regarding fertility preservation, identifying demographic, fertility and fertility preservation related factors, which may affect DC, and assessing the helpfulness of various decision-supports. METHODS: A retrospective, cross-sectional, web-based survey via an online questionnaire available in three languages with specific items concerning cancer, fertility, fertility preservation and the validated Decisional Conflict Scale targeted at current or former female cancer patients aged 18-45 years, with cancer types or treatment potentially affecting reproductive function...
November 17, 2017: Journal of Family Planning and Reproductive Health Care
https://www.readbyqxmd.com/read/29145813/impact-of-a-decision-aid-about-stratified-ovarian-cancer-risk-management-on-women-s-knowledge-and-intentions-a-randomised-online-experimental-survey-study
#2
Susanne F Meisel, Maddie Freeman, Jo Waller, Lindsay Fraser, Sue Gessler, Ian Jacobs, Jatinderpal Kalsi, Ranjit Manchanda, Belinda Rahman, Lucy Side, Jane Wardle, Anne Lanceley, Saskia C Sanderson
BACKGROUND: Risk stratification using genetic and other types of personal information could improve current best available approaches to ovarian cancer risk reduction, improving identification of women at increased risk of ovarian cancer and reducing unnecessary interventions for women at lower risk. Amounts of information given to women may influence key informed decision-related outcomes, e.g. knowledge. The primary aim of this study was to compare informed decision-related outcomes between women given one of two versions (gist vs...
November 16, 2017: BMC Public Health
https://www.readbyqxmd.com/read/29138520/prenatal-non-treatment-decisions-in-extreme-prematurity-evaluation-of-decisional-conflict-and-regret-among-parents
#3
R Geurtzen, J Draaisma, R Hermens, H Scheepers, M Woiski, A van Heijst, M Hogeveen
This corrects the article DOI: 10.1038/jp.2017.90.
November 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29132946/an-interview-study-of-patient-and-caregiver-perspectives-on-advance-care-planning-in-esrd
#4
Marcus Sellars, Josephine M Clayton, Rachael L Morton, Tim Luckett, William Silvester, Lucy Spencer, Carol A Pollock, Rowan G Walker, Peter G Kerr, Allison Tong
BACKGROUND: Advance care planning (ACP) empowers patients to consider and communicate their current and future treatment goals. However, it can be an emotionally charged process for patients with kidney disease and their caregivers. This study aimed to describe the perspectives and attitudes of patients with end-stage renal disease (ESRD) and their caregivers toward ACP. STUDY DESIGN: Qualitative study. SETTING & PARTICIPANTS: Patients with ESRD (n=24) and their caregivers (n=15) aged 36 to 91 years at various stages of ACP ("not commenced," "in progress," or "completed") from 3 renal services...
November 10, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29124494/information-and-support-needs-of-young-women-regarding-breast-cancer-risk-and-genetic-testing-adapting-effective-interventions-for-a-novel-population
#5
Suzanne C O'Neill, Chalanda Evans, Rebekah J Hamilton, Beth N Peshkin, Claudine Isaacs, Sue Friedman, Kenneth P Tercyak
Young women from hereditary breast and ovarian cancer (HBOC) families face a unique set of challenges in managing their HBOC risk, where obtaining essential information to inform decision making is key. Previous work suggests that this need for specific health information also comes at a time of heightened distress and greater individuation from family. In this report, we describe our adaptation of a previously-studied behavioral intervention for this population, utilizing a systematic approach outlined by the Centers for Disease Control and Prevention...
November 9, 2017: Familial Cancer
https://www.readbyqxmd.com/read/29114896/a-shared-decision-making-tool-for-obstructive-sleep-apnea-without-tonsillar-hypertrophy-a-randomized-controlled-trial
#6
Mathieu Bergeron, Angela L Duggins, Aliza P Cohen, Karin Tiemeyer, Lisa Mullen, Joseph Crisalli, Angela McArthur, Stacey L Ishman
OBJECTIVES/HYPOTHESIS: Shared decision-making is a process whereby patients and clinicians jointly establish a treatment plan integrating clinical evidence and patient values and preferences. Although this approach has been successfully employed in numerous medical disciplines, often using shared decision-making tools, otolaryngologic research assessing its use is scant. Our primary objective was therefore to determine if the tools we developed reduced decisional conflict for children with obstructive sleep apnea without tonsillar hypertrophy...
November 8, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29102996/prostatectomy-versus-radiotherapy-for-early-stage-prostate-cancer-prepare-study-protocol-for-a-mixed-methods-study-of-treatment-decision-making-in-men-with-localised-prostate-cancer
#7
Allan Ben Smith, Pascal Mancuso, Mark Sidhom, Karen Wong, Megan Berry, Orlando Rincones, Dion Forstner, Lesley Bokey, Afaf Girgis
BACKGROUND: Men diagnosed with localised prostate cancer (LPC) wanting curative treatment face a highly preference-sensitive choice between prostatectomy and radiotherapy, which offer similar cure rates but different side effects. This study aims to determine the information, decision-making needs and preferences of men with LPC choosing between robotic prostatectomy and standard external beam or stereotactic radiotherapy. METHODS AND ANALYSIS: This study will be conducted at a large public teaching hospital in Australia offering the choice between robotic prostatectomy and radiotherapy from early 2017...
November 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/29101469/triadic-treatment-decision-making-in-advanced-cancer-a-pilot-study-of-the-roles-and-perceptions-of-patients-caregivers-and-oncologists
#8
Thomas W LeBlanc, Nick Bloom, Steven P Wolf, Sarah G Lowman, Kathryn I Pollak, Karen E Steinhauser, Dan Ariely, James A Tulsky
PURPOSE: The research on cancer treatment decision-making focuses on dyads; the full "triad" of patients, oncologists, and caregivers remains largely unstudied. We investigated how all members of this triad perceive and experience decisions related to treatment for advanced cancer. METHODS: At an academic cancer center, we enrolled adult patients with advanced gastrointestinal or hematological malignancies, their caregivers, and their oncologists. Triad members completed a semi-structured qualitative interview and a survey measuring decisional conflict and perceived influence of the other triad members on treatment decisions...
November 4, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29083251/the-feasibility-of-sophisticated-multicriteria-support-for-clinical-decisions
#9
James G Dolan, Peter J Veazie
BACKGROUND: Multicriteria decision-making (MCDM) methods are well-suited to serve as the foundation for clinical decision support systems. To do so, however, they need to be appropriate for use in busy clinical settings. We compared decision-making processes and outcomes of patient-level analyses done with a range of multicriteria methods that vary in ease of use and intensity of decision support, 2 factors that could affect their ease of implementation into practice. METHODS: We conducted a series of Internet surveys to compare the effects of 5 multicriteria methods that differ in user interface and required user input format on decisions regarding selection of a preferred method for lowering the risk of cardiovascular disease...
October 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/29067837/shared-decision-making-for-psychiatric-medication-a-mixed-methods-evaluation-of-a-uk-training-programme-for-service-users-and-clinicians
#10
Shulamit Ramon, Nicola Morant, Ute Stead, Ben Perry
BACKGROUND: Shared decision making (SDM) is recognised as a promising strategy to enhance good collaboration between clinicians and service users, yet it is not practised regularly in mental health. AIMS: Develop and evaluate a novel training programme to enhance SDM in psychiatric medication management for service users, psychiatrists and care co-ordinators. METHODS: The training programme design was informed by existing literature and local stakeholders consultations...
October 1, 2017: International Journal of Social Psychiatry
https://www.readbyqxmd.com/read/29031121/facilitating-decision-making-in-women-undergoing-genetic-testing-for-hereditary-breast-cancer-breconda-randomized-controlled-trial-results
#11
Kerry A Sherman, Christopher J Kilby, Laura-Kate Shaw, Caleb Winch, Judy Kirk, Kathy Tucker, Elisabeth Elder
BACKGROUND: Decision-making concerning risk-reducing mastectomy for women at hereditary risk of breast cancer entails complex personal choices. Deciding whether and how to restore breast shape after risk-reducing mastectomy is a key part of this process. We developed a web-based decision aid, BRECONDA (Breast Reconstruction Decision Aid), to assist women in decision-making regarding breast reconstruction. METHOD: This study assessed the efficacy of BRECONDA to assist women at increased risk of breast cancer in making decisions regarding risk-reducing mastectomy in terms of decisional conflict, knowledge, and satisfaction with information...
December 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/29027472/using-decisional-conflict-to-evaluate-patient-engagement-during-hospital-discharge
#12
Erin P Dowling, Aram A Namavar, Sitaram Vangala, Ashley Busuttil, Nasim Afsar-Manesh
No abstract text is available yet for this article.
October 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28988175/assessment-of-the-effects-of-decision-aids-about-breast-cancer-screening-a-systematic-review-and-meta-analysis
#13
Montserrat Martínez-Alonso, Misericòrdia Carles-Lavila, Maria José Pérez-Lacasta, Anna Pons-Rodríguez, Montse Garcia, Montserrat Rué
OBJECTIVE: The aim of this systematic review and meta-analysis of randomised controlled trials (RCTs) and observational studies is to assess the effect of decision aids (DAs) in women aged 50 and below facing the decision to be screened for breast cancer. SETTING: Screening for breast cancer. INTERVENTION: DAs aimed to help women make a deliberative choice regarding participation in mammography screening by providing information on the options and outcomes...
October 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28986341/computerized-decision-aids-for-shared-decision-making-in-serious-illness-systematic-review
#14
Anna Staszewska, Pearl Zaki, Joon Lee
BACKGROUND: Shared decision making (SDM) is important in achieving patient-centered care. SDM tools such as decision aids are intended to inform the patient. When used to assist in decision making between treatments, decision aids have been shown to reduce decisional conflict, increase ease of decision making, and increase modification of previous decisions. OBJECTIVE: The purpose of this systematic review is to assess the impact of computerized decision aids on patient-centered outcomes related to SDM for seriously ill patients...
October 6, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28958987/tablet-based-patient-centered-decision-support-for-minor-head-injury-in-the-emergency-department-pilot-study
#15
Navdeep Singh, Erik Hess, George Guo, Adam Sharp, Brian Huang, Maggie Breslin, Edward Melnick
BACKGROUND: The Concussion or Brain Bleed app is a clinician- and patient-facing electronic tool to guide decisions about head computed tomography (CT) use in patients presenting to the emergency department (ED) with minor head injury. This app integrates a patient decision aid and clinical decision support (using the Canadian CT Head Rule, CCHR) at the bedside on a tablet computer to promote conversations around individualized risk and patients' specific concerns within the ED context...
September 28, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28958567/development-and-testing-of-a-decision-aid-for-women-considering-delayed-breast-reconstruction
#16
Kelly Metcalfe, Toni Zhong, Anne C O'Neill, David McCready, Linda Chan, Kate Butler, Sarah Brennenstuhl, Stefan O P Hofer
BACKGROUND: The decision to have post-mastectomy breast reconstruction (PMBR) is highly complex and many women feel ill equipped to make this decision. Decision aids have been advocated to promote patient involvement in decision-making by streamlining and standardizing communication between the patient and the health care professional. In this study, we report on the development and testing of a decision aid (DA) for breast cancer survivors considering delayed PMBR. METHODS: The DA was developed and evaluated in three phases...
September 12, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28933994/decision-making-for-people-living-with-dementia-by-their-carers-at-the-end-of-life-a-rapid-scoping-review
#17
Sue Barker, Mary Lynch, Jane Hopkinson
BACKGROUND: There are an increasing number of people living with dementia, as well as an expectation that care decisions are made collaboratively with those with the disease entering the end stage and their families. This has increased the burden on family carers. AIM: To explore the evidence on the decisional support needs of informal carers of people with end-stage dementia. DESIGN: A rapid scoping review was undertaken of peer-reviewed publications between 2000 and 2016, which included all health-care settings and the person's own home...
September 2, 2017: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/28927326/decision-outcomes-in-women-offered-noninvasive-prenatal-test-nipt-for-positive-down-screening-results
#18
Tsz-Kin Lo, Kelvin Yuen-Kwong Chan, Anita Sik-Yau Kan, Po-Lam So, Choi-Wah Kong, Shui-Lam Mak, Chung-Nin Lee
In this first Asian study, the decision outcomes (decision conflict, decision regret, and anxiety) of 262 pregnant women offered noninvasive prenatal test (NIPT) for high-risk Down screening results were assessed. Decision conflict was experienced by 3.5% and level of decisional regret low (mean score 15.7, 95%CI 13.2-18.3). All 13 cases of decisional regret were NIPT acceptors. Elevated anxiety was experienced by 55.9% at the time of decision making about NIPT and persistent in 30.3%. Insufficient knowledge about NIPT was associated with elevated anxiety at decision making (p = ...
September 19, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28918408/effectiveness-cost-utility-and-implementation-of-a-decision-aid-for-patients-with-localised-prostate-cancer-and-their-partners-study-protocol-of-a-stepped-wedge-cluster-randomised-controlled-trial
#19
Hoda H M Al-Itejawi, Cornelia F van Uden-Kraan, Peter M van de Ven, Veerle M H Coupé, André N Vis, Jakko A Nieuwenhuijzen, Jeroen A van Moorselaar, Irma M Verdonck-de Leeuw
INTRODUCTION: Patient decision aids (PDAs) have been developed to help patients make an informed choice for a treatment option. Despite proven benefits, structural implementation falls short of expectations. The present study aims to assess the effectiveness and cost-utility of the PDA among newly diagnosed patients with localised prostate cancer and their partners, alongside implementation of the PDA in routine care. METHODS/ANALYSIS: A stepped-wedge cluster randomised trial will be conducted...
September 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28901568/shared-decision-making-in-the-paediatric-field-a-literature-review-and-concept-analysis
#20
REVIEW
Eun Sook Park, In Young Cho
AIM: The concept of shared decision-making is poorly defined and often used interchangeably with related terms. The aim of this study was to delineate and clarify the concept of shared decision-making in the paediatric field. METHOD: Rodgers and Knafl's evolutionary concept analysis was used to delineate and clarify the concept. Following a search of the CINAHL, PubMed and MEDLINE databases and online journals between 1995 and 2016, we included a total of 42 articles that referred to shared decision-making in the paediatric field...
September 13, 2017: Scandinavian Journal of Caring Sciences
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