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Decisional conflict

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https://www.readbyqxmd.com/read/28422278/decipher-test-impacts-decision-making-among-patients-considering-adjuvant-and-salvage-treatment-after-radical-prostatectomy-interim-results-from-the-multicenter-prospective-pro-impact-study
#1
John L Gore, Marguerite du Plessis, María Santiago-Jiménez, Kasra Yousefi, Darby J S Thompson, Lawrence Karsh, Brian R Lane, Michael Franks, David Y T Chen, Mark Bandyk, Fernando J Bianco, Gordon Brown, William Clark, Adam S Kibel, Hyung L Kim, William Lowrance, Murugesan Manoharan, Paul Maroni, Scott Perrapato, Paul Sieber, Edouard J Trabulsi, Robert Waterhouse, Elai Davicioni, Yair Lotan, Daniel W Lin
BACKGROUND: Patients with prostate cancer and their providers face uncertainty as they consider adjuvant radiotherapy (ART) or salvage radiotherapy (SRT) after undergoing radical prostatectomy. The authors prospectively evaluated the impact of the Decipher test, which predicts metastasis risk after radical prostatectomy, on decision making for ART and SRT. METHODS: A total of 150 patients who were considering ART and 115 who were considering SRT were enrolled. Providers submitted a management recommendation before processing the Decipher test and again at the time of receipt of the test results...
April 19, 2017: Cancer
https://www.readbyqxmd.com/read/28417662/clinician-views-of-patient-decisional-conflict-when-deciding-between-dialysis-and-conservative-management-qualitative-findings-from-the-palliative-care-in-chronic-kidney-disease-packs-study
#2
Helen Noble, Kevin Brazil, Aine Burns, Sarah Hallahan, Charles Normand, Paul Roderick, Colin Thompson, Peter Maxwell, Magdi Yaqoob
BACKGROUND: Only a paucity of studies have addressed clinician perspectives on patient decisional conflict, in making complex decisions between dialysis and conservative management (renal supportive and palliative care). AIM: To explore clinician views on decisional conflict in patients with end-stage kidney disease. DESIGN: Interpretive, qualitative study. SETTING AND PARTICIPANTS: As part of the wider National Institute for Health Research, PAlliative Care in chronic Kidney diSease study, semi-structured interviews were conducted with clinicians (nephrologists n = 12; 7 female and clinical nurse specialists n = 15; 15 female) across 10 renal centres in the United Kingdom...
April 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28404208/predictors-of-physicians-communication-performance-in-a-decision-making-encounter-with-a-simulated-advanced-stage-cancer-patient-a-longitudinal-study
#3
Yves Libert, Delphine Canivet, Catherine Ménard, Laëtitia Van Achte, Christine Farvacques, Isabelle Merckaert, Aurore Liénard, Jean Klastersky, Christine Reynaert, Jean-Louis Slachmuylder, Jean-François Durieux, Nicole Delvaux, Darius Razavi
OBJECTIVES: Physicians' characteristics that influence their communication performance (CP) in decision-making encounters have been rarely studied. In this longitudinal study, predictors of physicians' CP were investigated with a simulated advanced-stage cancer patient. METHODS: Physicians (n=85) performed a decision-making encounter with a simulated patient (SP). Their CP was calculated by analyzing encounter transcripts with validated interaction analysis systems...
March 4, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28402085/decision-aids-for-people-facing-health-treatment-or-screening-decisions
#4
REVIEW
Dawn Stacey, France Légaré, Krystina Lewis, Michael J Barry, Carol L Bennett, Karen B Eden, Margaret Holmes-Rovner, Hilary Llewellyn-Thomas, Anne Lyddiatt, Richard Thomson, Lyndal Trevena
BACKGROUND: Decision aids are interventions that support patients by making their decisions explicit, providing information about options and associated benefits/harms, and helping clarify congruence between decisions and personal values. OBJECTIVES: To assess the effects of decision aids in people facing treatment or screening decisions. SEARCH METHODS: Updated search (2012 to April 2015) in CENTRAL; MEDLINE; Embase; PsycINFO; and grey literature; includes CINAHL to September 2008...
April 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28380700/an-exploratory-survey-of-older-women-s-post-fall-decisions
#5
Caroline D Bergeron, Daniela B Friedman, S Melinda Spencer, Susan C Miller, DeAnne K Hilfinger Messias, Robert McKeever
This research examined factors influencing older women's post-fall decision making. We surveyed 130 independent older women from continuing care retirement communities and non-institutional homes. We categorized women's post-fall decisions as medical, corrective, and social decisions, and examined the associations between post-fall decision categories, decisional conflict, number of post-fall changes, self-rated health, frequency of falls, severity of falls, health literacy, awareness and openness to long-term care institutional options, and demographics...
June 1, 2016: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/28376460/persuasive-interventions-for-controversial-cancer-screening-recommendations-testing-a-novel-approach-to-help-patients-make-evidence-based-decisions
#6
Barry G Saver, Kathleen M Mazor, Roger Luckmann, Sarah L Cutrona, Marcela Hayes, Tatyana Gorodetsky, Nancy Esparza, Gonzalo Bacigalupe
PURPOSE: We wanted to evaluate novel decision aids designed to help patients trust and accept the controversial, evidence-based, US Preventive Services Task Force recommendations about prostate cancer screening (from 2012) and mammography screening for women aged 40 to 49 years (from 2009). METHODS: We created recorded vignettes of physician-patient discussions about prostate cancer screening and mammography, accompanied by illustrative slides, based on principles derived from preceding qualitative work and behavioral science literature...
January 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28358384/field-testing-of-decision-coaching-with-a-decision-aid-for-parents-facing-extreme-prematurity
#7
G P Moore, B Lemyre, T Daboval, S Ding, S Dunn, S Akiki, N Barrowman, A L Shephard, M L Lawson
OBJECTIVE: The objective of this study is to assess and modify an existing decision aid and field-test decision coaching with the modified aid during consultations with parents facing potential delivery at 23 to 24 weeks gestation. STUDY DESIGN: International Patient Decision Aid Standards instrument (IPDASi) scoring deficits, multi-stakeholder group feedback and α-testing guided modifications. Feasibility/acceptability were assessed. The Decisional Conflict Scale was used to measure participants' decisional conflict before (T1) and immediately after (T2) the consultation...
March 30, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28337730/current-concepts-of-shared-decision-making-in-orthopedic-surgery
#8
REVIEW
Kevin Klifto, Christopher Klifto, James Slover
PURPOSE OF REVIEW: The Shared Decision Making (SDM) model, a collaborative decision making process between the physician and patient to make an informed clinical decision that enhances the chance of treatment success as defined by each patient's preferences and values, has become a new and promising tool in the healthcare process; however, minimal data exists on its application in the orthopedic surgical specialty. Increasing evidence has demonstrated that this once novel idea can be implemented successfully in the orthopedic setting to improve patient outcomes...
March 23, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28327125/facilitating-informed-decisions-about-breast-cancer-screening-development-and-evaluation-of-a-web-based-decision-aid-for-women-in-their-40s
#9
Elena B Elkin, Valerie H Pocus, Alvin I Mushlin, Tessa Cigler, Coral L Atoria, Margaret M Polaneczky
BACKGROUND: Expert groups and national guidelines recommend individualized decision making about screening mammography for women in their 40s at low-to-average risk of breast cancer. We created Breast Screening Decisions (BSD), a personalized, web-based decision aid, to help women decide when to start and how often to have routine screening mammograms. We evaluated BSD in a large, prospective pilot trial of women and their clinicians. METHODS: Women ages 40-49 were invited to use BSD before a scheduled preventive care visit...
March 21, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28327116/a-tailored-online-safety-and-health-intervention-for-women-experiencing-intimate-partner-violence-the-ican-plan-4-safety-randomized-controlled-trial-protocol
#10
Marilyn Ford-Gilboe, Colleen Varcoe, Kelly Scott-Storey, Judith Wuest, James Case, Leanne M Currie, Nancy Glass, Marilyn Hodgins, Harriet MacMillan, Nancy Perrin, C Nadine Wathen
BACKGROUND: Intimate partner violence (IPV) threatens the safety and health of women worldwide. Safety planning is a widely recommended, evidence-based intervention for women experiencing IPV, yet fewer than 1 in 5 Canadian women access safety planning through domestic violence services. Rural, Indigenous, racialized, and immigrant women, those who prioritize their privacy, and/or women who have partners other than men, face unique safety risks and access barriers. Online IPV interventions tailored to the unique features of women's lives, and to maximize choice and control, have potential to reduce access barriers, and improve fit and inclusiveness, maximizing effectiveness of these interventions for diverse groups...
March 21, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28320368/use-of-a-decision-aid-did-not-decrease-decisional-conflict-in-patients-with-carpal-tunnel-syndrome
#11
Hyun Sik Gong, Jin Woo Park, Young Ho Shin, Kahyun Kim, Kwan Jae Cho, Goo Hyun Baek
BACKGROUND: Although a model for shared decision-making is important for patient-centered care, decisional conflict can emerge when patients participate in the decision-making. A decision aid is proposed to provide information and to involve patients more comfortably in the decision-making process. We aimed to determine whether a decision aid helps patients with carpal tunnel syndrome (CTS) experience less decisional conflict regarding their decision-making for surgery. METHODS: Eighty patients with CTS were randomized into two groups...
March 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28295915/effectiveness-of-a-decision-aid-for-patients-with-depression-a%C3%A2-randomized-controlled-trial
#12
Lilisbeth Perestelo-Perez, Amado Rivero-Santana, Juan Antonio Sanchez-Afonso, Jeanette Perez-Ramos, Carmen Luisa Castellano-Fuentes, Karen Sepucha, Pedro Serrano-Aguilar
BACKGROUND: Shared decision making is an important component of patient-centred care and decision aids are tools designed to support patients' decision making and help patients with depression to make informed choices. OBJECTIVE: The study aim was to assess the effectiveness of a web-based decision aid for patients with unipolar depression. DESIGN: Randomized controlled trial. SETTING AND PARTICIPANTS: Adults diagnosed with a major depressive disorder and recruited in primary care centres were included and randomized to the decision aid (n=68) or usual care (n=79)...
March 10, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28278611/specific-words-and-experience-matter-to-surrogates-when-making-end-of-life-decisions
#13
Dawn E Fairlie
This grant funded preliminary study investigated the relationship between end-of-life terminologies and decisional conflict in surrogate decision makers using a convenience sample of 234 adults aged 50 and older. Participants were randomized into two groups; each received a survey packet that varied only in the use of the words "Do Not Resuscitate (DNR)" and "Allow Natural Death (AND)." The Decisional Conflict Scale (DCS) was administered and demographic data were collected. No difference was found in the total DCS scores based on the AND and DNR versions...
February 17, 2017: Health Communication
https://www.readbyqxmd.com/read/28277290/effect-of-a-decision-aid-with-patient-narratives-in-reducing-decisional-conflict-in-choice-for-surgery-among-early-stage-breast-cancer-patients-a-three-arm-randomized-controlled-trial
#14
Wakako Osaka, Kazuhiro Nakayama
OBJECTIVE: We aimed to evaluate the effect of a decision aid (DA) with patient narratives on decisional conflict in surgery choice for Japanese women with early-stage breast cancer. METHODS: Two hundred ten women with early-stage breast cancer were randomly assigned to an intervention or control group. Groups 1 and 2 received standard information and a DA, with or without patient narratives, and Group 3 received standard information (control) before surgery choice...
September 20, 2016: Patient Education and Counseling
https://www.readbyqxmd.com/read/28274664/psychological-outcomes-in-parents-of-critically-ill-hospitalized-children
#15
Robyn Stremler, Summer Haddad, Eleanor Pullenayegum, Christopher Parshuram
Parents of children in pediatric intensive care units (PICUs) are subjected to significant psychological stress. The purpose of this study was to determine the prevalence of, and factors associated with anxiety, depressive symptoms and decisional conflict in parents of children hospitalized in the PICU. The study employed a descriptive, cross-sectional design to investigate the psychological status of 118 parents of 91 children (74 mothers and 44 fathers) admitted to the PICU, using measures of anxiety (STAI), depression (CES-D), and decisional conflict (DCS)...
March 5, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28270129/a-digital-intake-approach-in-specialized-mental-health-care-study-protocol-of-a-cluster-randomised-controlled-trial
#16
Margot J Metz, Iman Elfeddali, David G H Krol, Marjolein A Veerbeek, Edwin de Beurs, Aartjan T F Beekman, Christina M van der Feltz-Cornelis
BACKGROUND: Enhancing patient participation is becoming increasingly important in mental health care as patients use to have a dependent, inactive role and nonadherence to treatment is a regular problem. Research shows promising results of initiatives stimulating patient participation in partnership with their clinicians. However, few initiatives targeting both patients' and clinicians' behaviour have been evaluated in randomised trials (RCT). Therefore, in GGz Breburg, a specialized mental health institution, a digital intake approach was developed aimed at exploring treatment needs, expectations and preferences of patients intended to prepare patients for the intake consultations...
March 7, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28258505/preparing-parents-to-make-an-informed-choice-about-antibiotic-use-for-common-acute-respiratory-infections-in-children-a-randomised-trial-of-brief-decision-aids-in-a-hypothetical-scenario
#17
Peter D Coxeter, Chris B Del Mar, Tammy C Hoffmann
BACKGROUND: Childhood acute respiratory infections (ARIs) are one of the most common reasons for primary care consultations and for receiving an antibiotic. Public awareness of antibiotic benefit and harms for these conditions is low. To facilitate informed decision making, ideally in collaboration with their doctor, parents need clear communication about benefits and harms. Decision aids may be able to facilitate this process. OBJECTIVE: The aim of this study was to evaluate the effectiveness of three decision aids about antibiotic use for common ARIs in children...
March 4, 2017: Patient
https://www.readbyqxmd.com/read/28243460/a-feasibility-randomised-controlled-trial-of-the-decide-intervention-dementia-carers-making-informed-decisions
#18
Kathryn Lord, Gill Livingston, Claudia Cooper
SUMMARY: Family carers report high levels of decisional conflict when deciding whether their relative with dementia can continue to be cared for in their own home. We tested, in a feasibility randomised controlled trial, the first decision aid (the DECIDE manual) aiming to reduce such conflict. Twenty family carers received the DECIDE intervention, and 21 received usual treatment. The intervention group had reduced decisional conflict compared with controls (mean difference -11.96, 95% confidence interval -20...
January 2017: BJPsych Open
https://www.readbyqxmd.com/read/28230397/weighted-integration-suggests-that-visual-and-tactile-signals-provide-independent-estimates-about-duration
#19
Danny M Ball, Derek H Arnold, Kielan Yarrow
Humans might possess either a single (amodal) internal clock or multiple clocks for different sensory modalities. Sensitivity could be improved by the provision of multiple signals. Such improvements can be predicted quantitatively, assuming estimates are combined by summation, a process described as optimal when summation is weighted in accordance with the variance associated with each of the initially independent estimates. This possibility was assessed for visual and tactile information regarding temporal intervals...
May 2017: Journal of Experimental Psychology. Human Perception and Performance
https://www.readbyqxmd.com/read/28228452/does-the-use-of-a-decision-aid-improve-decision-making-in-prosthetic-heart-valve-selection-a-multicenter-randomized-trial
#20
Nelleke M Korteland, Yunus Ahmed, David R Koolbergen, Marjan Brouwer, Frederiek de Heer, Jolanda Kluin, Eline F Bruggemans, Robert J M Klautz, Anne M Stiggelbout, Jeroen J J Bucx, Jolien W Roos-Hesselink, Peter Polak, Thanasie Markou, Inge van den Broek, Rene Ligthart, Ad J J C Bogers, Johanna J M Takkenberg
BACKGROUND: A Dutch online patient decision aid to support prosthetic heart valve selection was recently developed. A multicenter randomized controlled trial was conducted to assess whether use of the patient decision aid results in optimization of shared decision making in prosthetic heart valve selection. METHODS AND RESULTS: In a 5-center randomized controlled trial, patients were allocated to receive either standard preoperative care (control group) or additional access to the patient decision aid (intervention group)...
February 2017: Circulation. Cardiovascular Quality and Outcomes
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