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Decisional conflict

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https://www.readbyqxmd.com/read/28640670/rationale-and-design-of-the-lung-cancer-screening-implementation-evaluation-of-patient-centered-care-study
#1
Leah S Miranda, Santanu Datta, Anne C Melzer, Renda Soylemez Wiener, James M Davis, Betty C Tong, Sara E Golden, Christopher G Slatore
Screening for lung cancer using low-dose computed tomography (LDCT) has been demonstrated to reduce lung cancer-related mortality and is being widely implemented. Further research in this area is needed to assess the impact of screening on patient-centered outcomes. Here we describe the design and rationale for a new study entitled Lung Cancer Screening Implementation: Evaluation of Patient-Centered Care. The protocol is composed of an interconnected series of studies evaluating patients and clinicians who are engaged in lung cancer screening in real-world settings...
June 22, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28631959/advance-care-planning-for-patients-with-amyotrophic-lateral-sclerosis
#2
Benjamin H Levi, Zachary Simmons, Courtney Hanna, Allyson Brothers, Erik Lehman, Elana Farace, Megan Bain, Renee Stewart, Michael J Green
PURPOSE: To determine whether an advance care planning (ACP) decision-aid could improve communication about end-of-life treatment wishes between patients with amyotrophic lateral sclerosis (ALS) and their clinicians. METHODS: Forty-four patients with ALS (>21, English-speaking, without dementia) engaged in ACP using an interactive computer based decision-aid. Before participants completed the intervention, and again three months later, their clinicians reviewed three clinical vignettes, and made treatment decisions (n = 18) for patients...
March 5, 2017: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
https://www.readbyqxmd.com/read/28629329/personalised-informed-choice-on-evidence-and-controversy-on-mammography-screening-study-protocol-for-a-randomized-controlled-trial
#3
Anna Roberto, Cinzia Colombo, Giulia Candiani, Livia Giordano, Paola Mantellini, Eugenio Paci, Roberto Satolli, Mario Valenza, Paola Mosconi
BACKGROUND: In Italy women aged 50-69 are invited for a population-based breast cancer (BC) screening. Physicians, policy makers and patients associations agree on the need to inform women about the benefits and harms in order to permit an informed decision. Decision aids (DA) are an effective way to support people in their decisions about health. This trial aims to assess women's informed choices, according to their health literacy and values, on participating or not in BC screening for the first time...
June 19, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28628515/effectiveness-of-self-administered-decision-aids-for-people-invited-to-participate-in-colorectal-cancer-screening-a-systematic-review-protocol
#4
Mette Bach Larsen, Pernille Gabel, Berit Andersen
The objective is to assess the effectiveness of self-administered decision aids for people invited to participate in colorectal cancer screening. We will evaluate effects on informed choice, decisional conflict, knowledge, and participation in colorectal cancer screening.
June 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28623628/does-patient-preference-measurement-in-decision-aids-improve-decisional-conflict-a-randomized-trial-in-men-with-prostate-cancer
#5
Joseph D Shirk, Catherine M Crespi, Josemanuel D Saucedo, Sylvia Lambrechts, Ely Dahan, Robert Kaplan, Christopher Saigal
BACKGROUND: Shared decision making (SDM) has been advocated as an approach to medical decision making that can improve decisional quality. Decision aids are tools that facilitate SDM in the context of limited physician time; however, many decision aids do not incorporate preference measurement. OBJECTIVES: We aim to understand whether adding preference measurement to a standard patient educational intervention improves decisional quality and is feasible in a busy clinical setting...
June 16, 2017: Patient
https://www.readbyqxmd.com/read/28621754/environmental-human-health-and-socio-economic-effects-of-cement-powders-the-multicriteria-analysis-as-decisional-methodology
#6
Laura Moretti, Paola Di Mascio, Simona Bellagamba
The attention to sustainability-related issues has grown fast in recent decades. The experience gained with these themes reveals the importance of considering this topic in the construction industry, which represents an important sector throughout the world. This work consists on conducting a multicriteria analysis of four cement powders, with the objective of calculating and analysing the environmental, human health and socio-economic effects of their production processes. The economic, technical, environmental and safety performances of the examined powders result from official, both internal and public, documents prepared by the producers...
June 16, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28617426/prenatal-non-treatment-decisions-in-extreme-prematurity-evaluation-of-decisional-conflict-and-regret-among-parents
#7
R Geurtzen, J Draaisma, R Hermens, H Scheepers, M Woiski, A van Heijst, M Hogeveen
OBJECTIVE: To evaluate Decisional Conflict and Regret among parents regarding the decision on initiating comfort or active care in extreme prematurity and to relate these to decision-making characteristics. STUDY DESIGN: A nationwide, multicenter, cross-sectional study using an online survey in the Netherlands. Data were collected from March 2015 to March 2016 among all parents with infants born at 24(+0/7)-24(+6/7) weeks gestational age in 2010-2013. The survey contained a Decisional Conflict and Decision Regret Scale (potential scores range from 0 to 100) and decision-making characteristics...
June 15, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28612468/decision-making-processes-among-men-with-low-risk-prostate-cancer-a-survey-study
#8
Richard M Hoffman, Stephen K Van Den Eeden, Kimberly M Davis, Tania Lobo, George Luta, Jun Shan, David Aaronson, David F Penson, Amethyst D Leimpeter, Kathryn Taylor
OBJECTIVE: To characterize decision-making processes and outcomes among men expressing early treatment preferences for low-risk prostate cancer. METHODS: We conducted telephone surveys of men newly diagnosed with low-risk prostate cancer in 2012-14. We analyzed subject who had discussed prostate cancer treatment with a clinician and expressed a treatment preference. We asked about decision-making processes, including physician discussions, prostate-cancer knowledge, decision-making styles, treatment preference, and decisional conflict...
June 13, 2017: Psycho-oncology
https://www.readbyqxmd.com/read/28610580/parental-decision-making-involvement-and-decisional-conflict-a-descriptive-study
#9
Laura Boland, Jennifer Kryworuchko, Anton Saarimaki, Margaret L Lawson
BACKGROUND: Decisional conflict is a state of uncertainty about the best treatment option among competing alternatives and is common among adult patients who are inadequately involved in the health decision making process. In pediatrics, research shows that many parents are insufficiently involved in decisions about their child's health. However, little is known about parents' experience of decisional conflict. We explored parents' perceived decision making involvement and its association with parents' decisional conflict...
June 13, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28590834/comparison-of-the-effects-of-a-pharmaceutical-industry-decision-guide-and-decision-aids-on-patient-choice-to-intensify-therapy-in-rheumatoid-arthritis
#10
Richard W Martin, Ryan D Enck, Donald J Tellinghuisen, Aaron T Eggebeen, James D Birmingham, Andrew J Head
OBJECTIVE: To compare the effects a pharmaceutical industry decision guide and International Patient Decision Aids Standard (IPDAS) compliant patient decision aids (PtDA) on patient medication beliefs and choice to intensify therapy. METHODS: Rheumatoid arthritis (RA) patients, who had never taken etanercept (Enbrel), took part in a mail survey. They were presented with a hypothetical decision scenario where they were asked to consider adding etanercept to their current regimen...
July 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28590833/evaluation-of-a-decision-aid-for-women-with-epilepsy-who-are-considering-pregnancy-a-randomized-controlled-trial
#11
Amanda McGrath, Louise Sharpe, Suncica Lah, Kaitlyn Parratt
BACKGROUND: For many women with epilepsy (WWE), decision making about pregnancy is complicated by considerations such as the potential teratogenicity of antiepileptic drugs, offspring risk of epilepsy, seizure occurrence during pregnancy, and the challenges of parenting amidst poorly controlled seizures. OBJECTIVE: This proof-of-concept, randomized controlled trial aimed to evaluate a decision aid (DA) developed to help WWE decide if they should start or enlarge their families...
July 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28562285/navigating-decisional-discord-the-pediatrician-s-role-when-child-and-parents-disagree
#12
Bryan A Sisk, James DuBois, Eric Kodish, Joanne Wolfe, Chris Feudtner
From the time when children enter the preteen years onward, pediatric medical decision-making can entail a complex interaction between child, parents, and pediatrician. When the child and parents disagree regarding medical decisions, the pediatrician has the challenging task of guiding the family to a final decision. Unresolved discord can affect family cohesiveness, patient adherence, and patient self-management. In this article, we outline 3 models for the pediatrician's role in the setting of decisional discord: deference, advocative, and arbitrative...
May 12, 2017: Pediatrics
https://www.readbyqxmd.com/read/28544648/effects-of-a-web-based-patient-decision-aid-on-biologic-and-small-molecule-agents-for-rheumatoid-arthritis-answer-2-a-proof-of-concept-study
#13
Linda C Li, Chris Shaw, Diane Lacaille, Elaine Yacyshyn, C Allyson Jones, Cheryl Koehn, Alison M Hoens, Jasmina Geldman, Eric C Sayre, Graham Macdonald, Jenny Leese, Nick Bansback
OBJECTIVES: To assess the extent to which ANSWER-2, an interactive online patient decision aid, reduces patients' decisional conflict and improves their medication-related knowledge and self-management capacity. METHODS: We used a pre-post study design. Eligible participants had a diagnosis of rheumatoid arthritis (RA), had been recommended to start using a biologic or small molecule agent or to switch to a new one, and had Internet access. Access to ANSWER-2 was provided immediately after enrollment...
May 23, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28543737/conflict-when-making-decisions-about-dialysis-modality
#14
Nien-Hsin Chen, Yu-Ping Lin, Shu-Yuan Liang, Heng-Hsin Tung, Shiow-Luan Tsay, Tsae-Jyy Wang
AIMS AND OBJECTIVE: The two key aims of this study were to explore decisional conflict and its influencing factors on choosing dialysis modality in patients with end-stage renal diseases. The influencing factors investigated include demographics, pre-dialysis education, dialysis knowledge, decision self-efficacy, and social support. BACKGROUND: Making dialysis modality decisions can be challenging for patients with end-stage renal diseases; there are pros and cons to both haemodialysis and peritoneal dialysis...
May 25, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28516513/evaluating-an-educational-intervention-to-alleviate-distress-amongst-men-with-newly-diagnosed-prostate-cancer-and-their-partners
#15
Lindsay Hedden, Richard Wassersug, Sarah Mahovlich, Phil Pollock, Monita Sundar, Robert H Bell, Larry Goldenberg, Celestia S Higano
OBJECTIVE: To determine whether an education session alleviates distress for both patients with prostate cancer and their partners; and whether their partner's attendance at the session; and disease, treatment, and sociodemographic characteristics affect changes in distress levels. PATIENTS, SUBJECTS AND METHODS: We identified men with untreated prostate cancer at the Vancouver Prostate Centre between February 2015 and March 2016 who agreed to attend our education session...
May 17, 2017: BJU International
https://www.readbyqxmd.com/read/28507990/development-of-an-online-evidence-based-patient-information-portal-for-congenital-heart-disease-a-pilot-study
#16
Jonathan R G Etnel, Arie P J van Dijk, Jolanda Kluin, Robin A Bertels, Elisabeth M W J Utens, Eugene van Galen, Ad J J C Bogers, Johanna J M Takkenberg
OBJECTIVES: In response to an increased need for patient information on congenital heart disease in the Netherlands, we initiated a nationwide initiative to develop an online, evidence-based patient information portal, starting with a pilot project aimed at the subgroup of patients with congenital aortic and pulmonary valve disease. METHODS AND RESULTS: We developed an information portal that aims to (1) improve patient knowledge and involvement and to subsequently reduce anxiety and decisional conflict and improve mental quality of life and (2) to support physicians in informing and communicating with their patients...
2017: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28457208/the-choice-project-peer-workers-promoting-shared-decision-making-at-a-youth-mental-health-service
#17
Magenta Bender Simmons, Samantha Batchelor, Tara Dimopoulos-Bick, Deb Howe
OBJECTIVE: In youth mental health services, consumer participation is essential, but few implementation strategies exist to engage young consumers. This project evaluated an intervention implemented in an Australian youth mental health service that utilized peer workers to promote shared decision making via an online tool. METHODS: All new clients ages 16-25 were invited to participate in this nonrandomized comparative study, which used a historical comparison group (N=80)...
May 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28457025/decisional-conflict-between-treatment-options-among-end-stage-renal-disease-patients-evaluated-for-kidney-transplantation
#18
Laura McPherson, Mohua Basu, Jennifer Gander, Stephen O Pastan, Sumit Mohan, Michael S Wolf, Mariana Chiles, Allison Russell, Kristie Lipford, Rachel E Patzer
Although kidney transplantation provides a significant benefit over dialysis, many end-stage renal disease (ESRD) patients are conflicted about their decision to undergo kidney transplant. We aimed to identify the prevalence and characteristics associated with decisional conflict between treatment options in ESRD patients presenting for transplant evaluation. Among a cross-sectional sample of ESRD patients (n=464) surveyed in 2014 and 2015, we assessed decisional conflict through a validated 10-item questionnaire...
April 29, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28454985/use-of-a-17-gene-prognostic-assay-in-contemporary-urologic-practice-results-of-an-interim-analysis-in-an-observational-cohort
#19
Gregg Eure, Raymond Germany, Robert Given, Ruixiao Lu, Alan W Shindel, Megan Rothney, Richard Glowacki, Jonathan Henderson, Tim Richardson, Evan Goldfischer, Phillip G Febbo, Bela Denes
OBJECTIVE: To study the impact of genomic testing in shared decision making for men with clinically low risk prostate cancer (PCa). METHODS: Patients with clinically low-risk PCa were enrolled in a prospective, multi-institutional study of a validated 17-gene tissue-based RT-PCR assay (Genomic Prostate Score™; GPS). In this manuscript we report on outcomes in the first 297 patients enrolled in the study with valid 17-gene assay results and decision-change data...
April 25, 2017: Urology
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
#20
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
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