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Shared decision making

S Scambler, M Delgado, K Asimakopoulou
Objective This paper presents the results of a systematic review, designed to explore how patient-centred care (PCC) is defined in the dental literature.Method An electronic search of MEDLINE (1946-2012), Embase (1980-2012) PsycINFO (1806-2012), the Cochrane Library and non-peer reviewed literature was conducted using a standardised search protocol. Definitions of patient centred care were identified and scored on two criteria to evaluate quality of definition and quality/type of evidence.Results Of the 28 papers included in the review the majority provided definitions of PCC synonymous with good quality general care (holistic, humanitarian)...
October 21, 2016: British Dental Journal
Cecilia Dahlbäck, Jonas Manjer, Martin Rehn, Anita Ringberg
BACKGROUND: Shared decision-making is increasingly advocated in many countries. The aims of this study were to investigate whether patients receiving breast-conserving surgery at Skåne University Hospital Malmö, Sweden, perceived an offered possibility to join in the decision-making process regarding the surgical method; to identify potential determinants for not having perceived such an offer; and to study how this perception of being offered an opportunity to take part in the decision-making process affected satisfaction with the aesthetic outcome...
October 20, 2016: World Journal of Surgery
Irosh Fernando, Frans Henskens, Masoud Talebian
OBJECTIVE: Complex treatment decisions can be suboptimal due to lack of a reliable decision-making model, a need this paper aims to meet. METHOD: A model for making complex treatment decisions is introduced. RESULTS: The utility of the proposed method is demonstrated by making a complex treatment decision involving evaluation of clozapine treatment in a treatment-resistant patient. CONCLUSION: The proposed method implemented as a software tool can provide a framework for shared decision-making involving the patient...
October 10, 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
Deborah J Cohen, Sara R Keller, Gillian R Hayes, David A Dorr, Joan S Ash, Dean F Sittig
BACKGROUND: Patient-generated health data (PGHD) are health-related data created or recorded by patients to inform their self-care and understanding about their own health. PGHD is different from other patient-reported outcome data because the collection of data is patient-driven, not practice- or research-driven. Technical applications for assisting patients to collect PGHD supports self-management activities such as healthy eating and exercise and can be important for preventing and managing disease...
October 19, 2016: JMIR Human Factors
Chris Del Mar
Sore throat and acute sinusitis are not straightforward diagnoses. Trying to guess the responsible pathogen may not be the best approach. Being guided by empirical evidence may be more useful. It suggests some, but very few, benefits for antibiotics. This has to be balanced with some, but few, harms from antibiotics, including diarrhoea, rash and thrush. Prescribers should also be aware of the risk of antibiotic resistance for the individual, as well as for the population as a whole. GPs should explain the evidence for the benefits and the harms of antibiotics to patients within a shared decision-making framework...
August 2016: Australian Prescriber
Jessica Shaw, Rebecca Campbell, Debi Cain
Prior research has documented the problematic community response to sexual assault: the majority of sexual assaults reported to police are never prosecuted. Social dominance theory suggests that this response is a form of institutional discrimination, intended to maintain existing social structures, and that police personnel likely draw upon shared ideologies to justify their decision-making in sexual assault case investigations. This study drew upon social dominance theory to examine how police justified their investigatory decisions to identify potential leverage points for change...
October 18, 2016: American Journal of Community Psychology
Gabrielle Wong-Parodi, Wändi Bruine de Bruin
As the specter of climate change looms on the horizon, people will face complex decisions about whether to support climate change policies and how to cope with climate change impacts on their lives. Without some grasp of the relevant science, they may find it hard to make informed decisions. Climate experts therefore face the ethical need to effectively communicate to non-expert audiences. Unfortunately, climate experts may inadvertently violate the maxims of effective communication, which require sharing communications that are truthful, brief, relevant, clear, and tested for effectiveness...
October 17, 2016: Science and Engineering Ethics
Sezai Özkan, Jos J Mellema, Adam Nazzal, Sang-Gil Lee, David Ring
PURPOSE: Information gathering is a key component of shared decision making and has a measurable effect on treatment decisions. Access to health information might improve quality of care in hand surgery. Our purpose was to identify socio-demographic, condition-related, and psychosocial factors associated with online information-seeking behavior in patients with hand and upper-extremity conditions. METHODS: From June 2015 to February 2016, we enrolled 134 patients with an upper-extremity condition who presented to an outpatient hand surgery office at an urban level I trauma center in this cross-sectional study...
October 14, 2016: Journal of Hand Surgery
Manuela Casula, Lorenza Scotti, Elena Tragni, Luca Merlino, Giovanni Corrao, Alberico L Catapano
BACKGROUND AND AIMS: We aimed at describing the therapeutic approach in young adult patients diagnosed with heterozygous familial hypercholesterolemia (HeFH) and their adherence and persistence to treatment. METHODS: From regional administrative databases, individuals aged ≤40 years, who received exemption for HeFH between January 1, 2003 and December 31, 2011, and concomitantly started statin treatment, were identified. Within the first year of treatment, we evaluated therapeutic changes, adherence as MPR (medication possession ratio), persistence as continuous drug coverage without gaps ≥60 days, and influencing factors using log binomial models...
October 12, 2016: Atherosclerosis
Ellen A Lipstein, Daniel J Lovell, Lee A Denson, Sandra C Kim, Charles Spencer, Richard F Ittenbach, Maria T Britto
OBJECTIVES: To understand the association between parents' perceptions of the decision process and the decision outcomes in decisions about the use of biologics in pediatric chronic conditions. METHODS: We mailed surveys to parents of children with IBD (inflammatory bowel disease) or JIA (juvenile idiopathic arthritis) who had started treatment with biologics in the prior two years and were treated at either of 2 children's hospitals. The survey included measures of the decision process, including decision control and physician engagement, and decision outcomes, including conflict and regret...
September 30, 2016: Journal of Pediatric Gastroenterology and Nutrition
Zoe Marshman, Abdussalam Eddaiki, Hilary L Bekker, Philip E Benson
OBJECTIVES: To develop and evaluate a child-centred patient decision aid for young people, and their parents, supporting shared decision making about fixed orthodontic appliance treatment with dental health professionals, namely the Fixed Appliance Decision Aid (FADA). METHODS: The studies were undertaken in a UK teaching dental hospital orthodontic department in 2013-2014. The development phase involved an interview study with: (a) 10 patients (12-16 years old), and their parents, receiving orthodontic care to investigate treatment decision making and inform the content of the FADA and (b) 23 stakeholders critiquing the draft decision aid's content, structure and utility...
October 17, 2016: Journal of Orthodontics
Magenta B Simmons, Aurora Elmes, Joanne E McKenzie, Lyndal Trevena, Sarah E Hetrick
BACKGROUND: Appropriate treatment for youth depression is an important public health priority. Shared decision making has been recommended, yet no decision aids exist to facilitate this. OBJECTIVES: The main objective of this study was to evaluate an online decision aid for youth depression. DESIGN: An uncontrolled cohort study with pre-decision, immediately post-decision and follow-up measurements. SETTING AND PARTICIPANTS: Young people (n=66) aged 12-25 years with mild, mild-moderate or moderate-severe depression were recruited from two enhanced primary care services...
October 17, 2016: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
Fiona Wood, Katie Phillips, Adrian Edwards, Glyn Elwyn
OBJECTIVE: We aimed to observe how an Option Grid™ decision aid for clinical encounters might be used where an interpreter is present, and to assess the impact of its use on shared decision making. METHODS: Data were available from three clinical consultations between patient, clinician (a physiotherapist), and interpreter about knee osteoarthritis. Clinicians were trained in the use of an Option Grid decision aid and the tool was used. Consultations were audio-recorded, transcribed, and translated by independent translators into English...
September 22, 2016: Patient Education and Counseling
Robert F Kushner
Provision of dietary counseling in the office setting is enhanced by using team-based care and electronic tools. Effective provider-patient communication is essential for fostering behavior change: the key component of lifestyle medicine. The principles of communication and behavior change are skill-based and grounded in scientific theories and models. Motivational interviewing and shared decision making, a collaboration process between patients and their providers to reach agreement about a health decision, is an important process in counseling...
November 2016: Medical Clinics of North America
Camilla S Hanson, Jonathan C Craig, Allison Tong
Patient- and family-centered care is hailed as a hallmark of high-quality pediatric care. This partnership between patients, families and their healthcare providers is central to caring for children with chronic kidney disease (CKD), given the long-term and profound impact of the disease and its treatment on the development and quality of life of these children. This paradigm hinges on a comprehensive and detailed understanding of the needs, beliefs and values of children with CKD and their families. However, their perspectives may remain undisclosed during time-limited clinical consultations and because of beliefs that if they did disclose their concerns, their care would be jeopardized...
October 15, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Janet Landeen, Donna Carr, Kirsten Culver, Lynn Martin, Nancy Matthew-Maich, Charlotte Noesgaard, Larissa Beney-Gadsby
Ongoing curricular renewal is a necessary phenomenon in nursing education to align learning with ever-changing professional practice demands. The McMaster Mohawk Conestoga BScN Program in Hamilton, Ontario, Canada recently engaged in a comprehensive curriculum renewal. The purpose of this study was to evaluate the impact of curricular changes on students' deep learning. Faculty perceptions about student learning outcomes during final year clinical placements were gathered through a combination of individual interviews and focus groups using Interpretive Descriptive qualitative research methodology...
October 4, 2016: Nurse Education in Practice
Silvia Orsulic-Jeras, Carol J Whitlatch, Sarah M Szabo, Evan G Shelton, Justin Johnson
This article describes the implementation of SHARE (Support, Health, Activities, Resources, and Education), a counseling-based care-planning intervention for persons living with early-stage dementia and their family caregivers (CGs). The foundation of SHARE is built upon assessing and documenting the person living with dementia's care values and preferences for future care. Using the SHARE approach, CGs are given an opportunity to achieve an understanding of their loved one's desires before the onset of disease progression when the demand for making care decisions is high...
October 13, 2016: Dementia
Tim J Gabbett, Rod Whiteley
We have observed that in professional sporting organisations the staff responsible for physical preparation and medical care typically practice in relative isolation and display tension in regards their attitudes toward training load prescription (much more, and much less training respectively). Recent evidence shows that relatively high chronic training loads, when they are appropriately reached, are associated with reduced injury risk and better performance. Understanding this link between performance and training loads removes this tension, but requires a better understanding of the relationship between the acute:chronic workload ratio (ACWR), and it's association with performance and injury...
October 13, 2016: International Journal of Sports Physiology and Performance
Maria Elena Miletto Petrazzini, Christian Agrillo, Véronique Izard, Angelo Bisazza
Numerous studies have shown that many animal species can be trained to discriminate between stimuli differing in numerosity. However, in the absence of generalization tests with untrained numerosities, what decision criterion was used by subjects remains unclear: the subjects may succeed by selecting a specific number of items (a criterion over absolute numerosities), or by applying a more general relative numerosity rule, for example, selecting the larger/smaller quantity of items. The latter case may require more powerful representations, supporting judgments of order ("more/less") beyond simple "same/different" judgments, but a relative numerosity rule may also be more adaptive...
October 13, 2016: Journal of Comparative Psychology
Kelsey A Bonfils, Kimberly C Dreison, Lauren Luther, Sadaaki Fukui, Abigail E Dempsey, Charles A Rapp, Michelle P Salyers
Objective: Although shared decision making (SDM) is a key element of client-centered care, it has not been widely adopted. Accordingly, interventions have been developed to promote SDM. The aim of this study was to explore the implementation process of one SDM intervention, CommonGround, which utilizes peer specialists and a computerized decision support center to promote SDM. Method: As part of a larger study, CommonGround was implemented in 4 treatment teams in a community mental health center. The implementation process was examined by conducting semistructured interviews with 12 staff members that were integral to the CommonGround implementation...
October 10, 2016: Psychiatric Rehabilitation Journal
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