scholarly journals How are caregivers involved in treatment decision making for older people with dementia and a new diagnosis of cancer?

2019 ◽  
Vol 28 (6) ◽  
pp. 1197-1206 ◽  
Author(s):  
Charlene Martin ◽  
Anne Shrestha ◽  
Maria Burton ◽  
Karen Collins ◽  
Lynda Wyld
Keyword(s):  
Decision Making ◽  
Older People ◽  
Treatment Decision ◽  
Treatment Decision Making ◽  
People With Dementia ◽  
Diagnosis Of Cancer ◽  
New Diagnosis

HSR19-089: Misperceptions Regarding Palliative and Hospice Care Among Cancer Patients: What Can We Learn from Patient-Reported Treatment Decision Making

2019 ◽  
Vol 17 (3.5) ◽  
pp. HSR19-089
Author(s):  
Sara Hayes ◽  
Brian M. Green ◽  
Shayna Yeates ◽  
Amrita Bhowmick ◽  
Kaitlyn McNamara ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Decision Making ◽  
Palliative Care ◽  
Cancer Care ◽  
Hospice Care ◽  
Treatment Decision ◽  
Treatment Decisions ◽  
Treatment Decision Making ◽  
Diagnosis Of Cancer

Background: Despite NCCN Guidelines and clear definition of palliative care, patients often carry misperceptions about palliative care and how it can be beneficially integrated into a patient’s care plan. In order to better understand the misinformation about palliative and hospice care, this study aims to assess patient-healthcare provider (HCP) communication regarding treatment decisions. Methods: An online survey was conducted with individuals who have had a diagnosis of cancer (n=1,517) to better understand their healthcare experiences as well as the impact their cancer diagnosis had on their quality of life. Measures included agreement scale questions assessing patient information needs surrounding treatment decision making. Open-ended questions where respondents were prompted to provide a written response allowed researchers to further assess patients’ understanding of palliative and hospice care. Responses to agreement-scale questions were evaluated using descriptive statistics. Openended question responses were analyzed using Dedoose qualitative data analysis software. Results: Among patients with a diagnosis of cancer, there were a broad range of patient misperceptions regarding palliative care, hospice care, and how they are used in cancer care. The majority of respondents (81%) stated that their HCP played a role when deciding on their treatment plan. Despite this, only 46% were confident they knew about the treatment’s impact on their daily life, 56% were confident they knew about the potential side effects of treatment, and 57% felt they had all of the information they needed. Themes identified through qualitative analysis include: patient conflation of palliative and hospice care, belief that palliative and hospice care are only relevant to end-of-life decision-making, and uncertainty about whether quality of life can actually be improved. Conclusions: Institutions and HCPs are recommended to integrate palliative care into cancer care. However, as this research shows, oncology patients are often misinformed about the benefits of palliative care. This follows a parallel concern of patients making treatment decisions without optimal information. A potential factor behind this unmet need may be lack of effective communication between patient and HCP. Palliative care may be mentioned by the HCP, but not discussed with enough empathy or depth, leading to patient misunderstanding and lack of inclusion in treatment plans.

scholarly journals P1.07-14 Frailty and Treatment Decision Making in Older People with Lung Cancer

2019 ◽  
Vol 14 (10) ◽  
pp. S492
Author(s):  
A. Tod ◽  
J. Skilbeck ◽  
C. Warnock ◽  
N. Ali ◽  
J. Ulman
Keyword(s):  
Lung Cancer ◽  
Decision Making ◽  
Older People ◽  
Treatment Decision ◽  
Treatment Decision Making

scholarly journals Role of Health Information Technology in the Engagement Process of Older Adults’ Cancer Treatment Decision Making

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 101-101
Author(s):  
Maryum Zaidi ◽  
Priscilla Gazarian ◽  
Heather Mattie ◽  
Lisa Kennedy Sheldon ◽  
C Ann Gakumo
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Information Technology ◽  
Health Information Technology ◽  
Health Information ◽  
Treatment Decision ◽  
Treatment Decision Making ◽  
Engagement Process ◽  
Diagnosis Of Cancer

Abstract This study investigates the role of Health Information Technology (HIT) in the process of patient engagement in treatment decision making in older adults in cancer care. Despite the role of HIT in patient engagement processes and government incentives for HIT development, research regarding HIT is lacking among older adults. The following study is a secondary data analysis of a subset of the Health Information National Trend Survey (HINTS 4, Cycle 3), including individuals 65 years old and above. Chi-square tests, logistic regression, and linear regression models were fit to study several sociodemographic, socioeconomic, and psychosocial variables in this study. The results show that education, poverty status, and self-management domain of the patient activation (which is a precursor of the engagement process) were significantly associated with access to and utilization of HIT. No significant differences between access to and utilization of HIT and the diagnosis of cancer were found. However, fatalistic beliefs about the diagnosis of cancer significantly impacted the use of HIT in all models, including those controlling for cancer diagnosis and access to HIT. Specifically, a one-point increase in cancer fatalism score is associated with a 59% decrease in the utilization of HIT, giving evidence that fatalistic beliefs about cancer can drive engagement behaviors regardless of a diagnosis of cancer. Our study provides vital information for providers and policy researchers to take into account for future implementation and development strategies of HIT in cancer care for older adults.

scholarly journals Bridging the divide: the adjustment and decision-making experiences of people with dementia living with a recent diagnosis of cancer and its impact on family carers

2018 ◽  
Vol 40 (5) ◽  
pp. 944-965 ◽  
Author(s):  
Lorna McWilliams ◽  
Caroline Swarbrick ◽  
Janelle Yorke ◽  
Lorraine Burgess ◽  
Carole Farrell ◽  
...  
Keyword(s):  
Decision Making ◽  
Cancer Treatment ◽  
Treatment Options ◽  
Treatment Decision ◽  
Vital Role ◽  
Family Carers ◽  
Structured Interviews ◽  
Cancer Symptoms ◽  
People With Dementia ◽  
Diagnosis Of Cancer

AbstractThe risk of living with dementia and, separately, cancer, increases exponentially with age. However, to date, there is a paucity of research investigating the experiences of people living with both these conditions. This study used semi-structured interviews to explore the decision-making and treatment options for people who live with both dementia and cancer. In total, ten people living with both dementia and cancer (aged 39–93 years) and nine family carers were interviewed. Braun and Clarke's approach to thematic analysis was used together with framework matrices to organise the data. In this article four sequential and descriptive themes are presented. ‘Reaching a diagnosis of cancer’ describes the vital role that family carers play in encouraging the person with dementia to seek an explanation for their presenting (undiagnosed cancer) symptoms to their general practitioner. ‘Adjusting to the cancer diagnosis when living with dementia’ outlines a variety of emotional and practical responses to receiving news of the diagnosis. ‘Weighing up the cancer treatment options’ highlights the different decisions and circumstances that family carers and people living with both dementia and cancer are faced with post-diagnosis. ‘Undergoing cancer treatment’ shares the finding that cancer treatment decision-making was not straightforward and that people living with both dementia and cancer would often forget about their cancer and what procedures they had been through.

Patterns of decision making about cancer clinical trial participation among the online cancer treatment community: A collaboration between SWOG and NexCura.

2012 ◽  
Vol 30 (18_suppl) ◽  
pp. CRA6009-CRA6009 ◽  
Author(s):  
Joseph M Unger ◽  
Dawn L. Hershman ◽  
Kenda Burg ◽  
Carol Moinpour ◽  
Kathy S. Albain ◽  
...  
Keyword(s):  
Decision Making ◽  
Demographic Factors ◽  
Participation Rate ◽  
Treatment Decision ◽  
Trial Participation ◽  
Lower Income ◽  
Treatment Decision Making ◽  
Study Results ◽  
New Diagnosis ◽  
The Impact

CRA6009 Background: Studies have shown an association between socioeconomic status (SES) and quality of oncology care, but less is known about the impact of SES on decision-making about CT participation. Methods: We assessed patterns of CT treatment decision-making according to important SES and demographic factors (age, sex, race, income, education) in a large sample of patients surveyed via a web-based treatment decision tool (NexCura, The Woodlands, TX). Eligible patients had a new diagnosis of breast, lung, colorectal, or prostate cancer, and were >18. Logistic regression (conditioning on type of cancer) was used. Reasons for non-participation in CTs were assessed using pre-specified items about treatment, family, cost, and logistics. All data were self-reported. Results: 5,499 patients were surveyed from 2007-2011. 40% discussed CTs with their physician; this differed by age (42% <65 v. 29% >65), income (42% >$50k/yr v. 36% <$50k/yr), and education (42% >college degree (CD) v. 37% <CD). 45% of discussions led to offers of CT participation, and 51% of offers led to CT participation. The overall CT participation rate was 9%, differing by age, income, and education (see table below). In a multivariate model including all SES and demographic factors (plus covariates comorbidity status and “distance to clinic”, a surrogate for convenience), income remained a predictor of CT participation (OR 0.73, 95% CI, 0.57-0.94, p=.01). Even in patients >65, who are nearly universally covered by Medicare, lower income predicted reduced CT participation (age by income interaction test, p>.05). Cost concerns were much more evident among lower income patients (p=.0001). Conclusions: Lower income patients were less likely to participate in CTs, even when considering age group.A better understanding of why income is a barrier may help identify ways to make CTs better available to all patients, and would increase the generalizability of CT study results across all levels of SES. [Table: see text]

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