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Decisional conflict

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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
#1
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
#2
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
https://www.readbyqxmd.com/read/28899412/the-effect-of-information-about-the-benefits-and-harms-of-mammography-on-women-s-decision-making-study-protocol-for-a-randomized-controlled-trial
#3
Misericòrdia Carles, Montserrat Martínez-Alonso, Anna Pons, Maria José Pérez-Lacasta, Lilisbeth Perestelo-Pérez, Maria Sala, Carmen Vidal, Montse Garcia, Ana Toledo-Chávarri, Núria Codern, Maria Feijoo-Cid, Anabel Romero, Roger Pla, Jorge Soler-González, Xavier Castells, Montserrat Rué
BACKGROUND: The decision to participate or not in breast cancer screening is complex due to the trade-off between the expected benefit of breast cancer mortality reduction and the major harm of overdiagnosis. It seems ethically necessary to inform women so that they can actively participate in decision-making and make an informed choice based on their values and preferences. The objective of this study is to assess the effects of receiving information about the benefits and harms of screening on decision-making, in women approaching the age of invitation to mammography screening...
September 12, 2017: Trials
https://www.readbyqxmd.com/read/28888264/availability-of-patient-decision-aids-for-stroke-prevention-in-atrial-fibrillation-a-systematic-review
#4
REVIEW
Elizabeth S O'Neill, Stuart W Grande, Ariel Sherman, Glyn Elwyn, Megan Coylewright
BACKGROUND: Atrial fibrillation is a common irregular heart rhythm that increases patients' risk of stroke. Aspirin, warfarin, direct oral anticoagulants, and an implantable device can reduce this risk. Given the availability of multiple comparable options, this decision depends on patient preferences and is appropriate for the use of decision aids and other efforts to promote shared decision making. The objective of this review was to examine the existence and accessibility of, as well as select outcomes associated with, published, formally evaluated patient decision aids for stroke prevention in atrial fibrillation...
September 2017: American Heart Journal
https://www.readbyqxmd.com/read/28877862/effectiveness-of-a-web-based-tailored-intervention-with-virtual-assistants-promoting-the-acceptability-of-hpv-vaccination-among-mothers-of-invited-girls-randomized-controlled-trial
#5
Mirjam Pot, Theo Gwm Paulussen, Robert Ac Ruiter, Iris Eekhout, Hester E de Melker, Maxine Ea Spoelstra, Hilde M van Keulen
BACKGROUND: In 2010, the human papillomavirus (HPV) vaccination was introduced in the Dutch National Immunization Program for 12-year-old girls, aiming to reduce the incidence of cervical cancer in women. HPV vaccination uptake turned out to be lower than expected: 61% versus 70%, respectively. Mothers were shown to play the most important role in the immunization decision about this vaccination. They had also expressed their need for interactive personal information about the HPV vaccination over and above the existing universal general information...
September 6, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28873215/group-genetic-counseling-an-alternate-service-delivery-model-in-a-high-risk-prenatal-screening-population
#6
Mireille Cloutier, Lauren Gallagher, Claire Goldsmith, Salwa Akiki, Nick Barrowman, Shawna Morrison
OBJECTIVE: To address the growing demand for prenatal genetics services, group genetic counseling was explored as an alternative service delivery model for women with a positive prenatal screening result. METHOD: Women were recruited from a prenatal genetics service and systematically allocated to a traditional individual appointment with a genetic counselor or a group genetic counseling session. Questionnaires were administered to assess patient psychological outcomes, knowledge and satisfaction following individual and group genetic counseling for a positive prenatal screen...
September 5, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28844330/a-randomised-controlled-trial-evaluating-the-utility-of-a-patient-decision-aid-to-improve-clinical-trial-raves-08-03-related-decision-making
#7
Puma Sundaresan, Brittany Ager, Sandra Turner, Dan Costa, Andrew Kneebone, Maria Pearse, Henry Woo, Stephanie Tesson, Ilona Juraskova, Phyllis Butow
BACKGROUND AND PURPOSE: Randomised controlled trials (RCTs) are considered the 'gold-standard' for evaluating medical treatments. However, patients and clinicians report difficulties with informed consent and recruitment. We evaluated the utility of a Decision Aid (DA) in reducing RCT-related decisional conflict, and improving RCT knowledge and recruitment. MATERIALS AND METHODS: Potential participants for a radiotherapy RCT were invited to participate in the current study...
August 22, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28840485/how-surrogates-decide-a-secondary-data-analysis-of-decision-making-principles-used-by-the-surrogates-of-hospitalized-older-adults
#8
Rohit Devnani, James E Slaven, Gabriel T Bosslet, Kianna Montz, Lev Inger, Emily S Burke, Alexia M Torke
BACKGROUND: Many hospitalized adults do not have the capacity to make their own health care decisions and thus require a surrogate decision-maker. While the ethical standard suggests that decisions should focus on a patient's preferences, our study explores the principles that surrogates consider most important when making decisions for older hospitalized patients. OBJECTIVES: We sought to determine how frequently surrogate decision-makers prioritized patient preferences in decision-making and what factors may predict their doing so...
August 24, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28827369/discordance-between-patients-stated-values-and-treatment-preferences-for-end-of-life-care-results-of-a-multicentre-survey
#9
Daren K Heyland, Rebecca Heyland, Peter Dodek, John J You, Tasnim Sinuff, Tim Hiebert, Xuran Jiang, Andrew G Day
BACKGROUND: Medical orders for the use of life-supports should be informed by patients' values and treatment preferences. The purpose of this study was to explore the internal consistency of patients' (or their family members') stated values, and the relationship between these values and expressed preferences. METHODS: We conducted a prospective study in 12 acute care hospitals in Canada. We administered a questionnaire to elderly patients and their family members about their values related to end-of-life (EOL) care, treatment preferences and decisional conflict...
September 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28768060/factors-associated-with-shared-decision-making-among-primary-care-physicians-findings-from-a-multicentre-cross-sectional-study
#10
Matthew Menear, Mirjam Marjolein Garvelink, Rhéda Adekpedjou, Maria Margarita Becerra Perez, Hubert Robitaille, Stéphane Turcotte, France Légaré
BACKGROUND: Despite growing recognition that shared decision making (SDM) is central for patient-centred primary care, adoption by physicians remains limited in routine practice. OBJECTIVE: To examine the characteristics of physicians, patients and consultations associated with primary care physicians' SDM behaviours during routine care. METHODS: A multicentre cross-sectional survey study was conducted with 114 unique patient-physician dyads recruited from 17 primary care clinics in Quebec and Ontario, Canada...
August 2, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28760277/randomized-controlled-trial-of-a-patient-decision-making-aid-for-orthodontics
#11
RANDOMIZED CONTROLLED TRIAL
Kate Parker, Susan J Cunningham, Aviva Petrie, Fiona S Ryan
INTRODUCTION: Patient decision-making aids (PDAs) are instruments that facilitate shared decision making and enable patients to reach informed, individual decisions regarding health care. The objective of this study was to assess the efficacy of a PDA compared with traditional information provision for adolescent patients considering fixed appliance orthodontic treatment. METHODS: Before treatment, orthodontic patients were randomly allocated into 2 groups: the intervention group received the PDA and standard information regarding fixed appliances, and the control group received the standard information only...
August 2017: American Journal of Orthodontics and Dentofacial Orthopedics
https://www.readbyqxmd.com/read/28759303/fertility-preservation-in-young-female-cancer-patients-development-and-pilot-testing-of-an-online-decision-aid
#12
Verena Ehrbar, Corinne Urech, Christoph Rochlitz, Rosanna Zanetti Dällenbach, Rebecca Moffat, Ruth Stiller, Monika Fäh, Michael von Wolff, Frank Nawroth, Astrid Dangel, Ariane Germeyer, Sebastian Findeklee, Sibil Tschudin
PURPOSE: Impairment of fertility is a common sequela of successful cancer treatment. Therefore, fertility preservation (FP) should be discussed with all young cancer patients. Decisions about FP are challenging. Patients wish more specific support and the first results concerning the helpfulness of decision aids (DA) were promising. Aside from describing the process of development and the content of an online DA in German, the objective of this study was to pilot test users' satisfaction with the DA and its effect on knowledge about FP and decisional conflict (DC)...
July 31, 2017: Journal of Adolescent and Young Adult Oncology
https://www.readbyqxmd.com/read/28754540/decision-support-with-the-personal-patient-profile-prostate-a-multi-center-randomized-trial
#13
Donna L Berry, Fangxin Hong, Traci M Blonquist, Barbara Halpenny, Christopher P Filson, Viraj A Master, Martin G Sanda, Peter Chang, Gary W Chien, Randy A Jones, Tracey L Krupski, Seth Wolpin, Leslie Wilson, Julia H Hayes, Quoc-Dien Trinh, Mitchell Sokoloff, Prabhakara Somayaji
PURPOSE: The purpose was to evaluate the efficacy of the Web-based, Personal Patient Profile-Prostate decision aid versus usual care with regard to decisional conflict in men with localized prostate cancer. MATERIALS AND METHODS: A randomized (1:1) controlled, parallel-group, nonblinded trial was conducted in four US regions. Eligible men had clinically localized prostate cancer, an upcoming consult, and spoke/read English or Spanish. Participants answered questionnaires to report decision-making stage, personal characteristics, concerns and preferences plus baseline symptoms and decisional conflict...
July 25, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28712797/evaluation-of-a-patient-decision-aid-for-unicompartmental-or-total-knee-arthroplasty-for-medial-knee-osteoarthritis
#14
Christopher de Jesus, Dawn Stacey, Geoffrey F Dervin
BACKGROUND: Many patients with isolated medial compartment osteoarthritis are candidates for either unicompartmental knee arthroplasty (UKA) or total knee arthroplasty (TKA). A novel patient decision aid (PDA) was developed to educate patients on both interventions and prepare them for making the decision with their surgeon. The study objective was to evaluate the acceptability and usefulness of a PDA for informing and helping patients reach a surgical preference without increasing decisional conflict...
June 17, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28680686/cross-sensory-modulation-in-a-future-top-predator-the-young-nile-crocodile
#15
Laura Chabrolles, Gérard Coureaud, Nicolas Boyer, Nicolas Mathevon, Marilyn Beauchaud
Animals routinely receive information through different sensory channels, and inputs from a modality may modulate the perception and behavioural reaction to others. In spite of their potential adaptive value, the behavioural correlates of this cross-sensory modulation have been poorly investigated. Due to their predator life, crocodilians deal with decisional conflicts emerging from concurrent stimuli. By testing young Crocodylus niloticus with sounds in the absence or presence of chemical stimuli, we show that (i) the prandial (feeding) state modulates the responsiveness of the animal to a congruent, i...
June 2017: Royal Society Open Science
https://www.readbyqxmd.com/read/28679882/decisional-conflict-in-work-related-hand-trauma-patients
#16
Hsien-Hua Liao, Sun-Long Cheng, Pei-Wei Shueng, Hsi-Chieh Lee, Chalong Cheewakriangkrai, Chi-Chang Chang
Often, clinical decision making of reconstructive procedure is coupled and their concurrent resolution by interacting stakeholders is required. This study was to give new insight into the tradeoff method to elicit the utility function first and then the probability weighting function, to determine if and how stakeholder engagement can contribute to managing decisional conflict processes. The proposed methodology is illustrated through three subjects (physician, patient and family member). We found that significant evidence of probability weighting both at the aggregate level and at the individual subject level...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28661491/informed-decision-making-and-psychosocial-outcomes-in-pregnant-and-nonpregnant-women-offered-population-fragile-x-carrier-screening
#17
Sylvia A Metcalfe, Melissa Martyn, Alice Ames, Vicki Anderson, Alison D Archibald, Grad Dip Gen Couns, Rob Carter, Jonathan Cohen, Megan Cotter, M GenCouns, William Dang, Martin B Delatycki, Susan Donath, Samantha Edwards, PGrad Dip Educ, Grad Dip Gen Couns, Robin Forbes, Grad Dip Gen Couns, Mioara Gavrila, M MedSci, Jane Halliday, Chriselle Hickerton, Melissa Hill, Grad Dip Gen Couns, Lorilli Jacobs, PGrad Dip Ultrasound, Vicki Petrou, Grad Dip Gen Couns, Loren Plunkett, M GenCouns, Leslie Sheffield, F Racp, Alison Thornton, Grad Dip Gen Couns, Sandra Younie, PGrad Dip Hlth Econ, Jon D Emery
PurposePopulation-based carrier screening for fragile X syndrome (FXS) is still not universally endorsed by professional organizations due to concerns around genetic counseling for complex information and potential for psychosocial harms.MethodsWe determined uptake levels, decision making, and psychosocial impact in a prospective study of pregnant and nonpregnant Australian women offered FXS carrier screening in clinical settings. Women received pretest genetic counseling, and completed questionnaires when deciding and one month later...
June 29, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/28659137/factors-influencing-decision-regret-regarding-placement-of-a-peg-among-substitute-decision-makers-of-older-persons-in-japan-a-prospective-study
#18
Yumiko Kuraoka, Kazuhiro Nakayama
BACKGROUND: A tube feeding decision aid designed at the Ottawa Health Research Institute was specifically created for substitute decision-makers who must decide whether to allow placement of a percutaneous endoscopic gastrostomy (PEG) tube in a cognitively impaired older person. We developed a Japanese version and found that the decision aid promoted the decision-making process of substitute decision-makers to decrease decisional conflict and increase knowledge. However, the factors that influence decision regret among substitute decision-makers were not measured after the decision was made...
June 28, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28640670/rationale-and-design-of-the-lung-cancer-screening-implementation-evaluation-of-patient-centered-care-study
#19
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
#20
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...
August 2017: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
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