Threats from patients and their effects on medical decision making: a cross-sectional, randomised trial

The Lancet ◽  
2001 ◽  
Vol 357 (9264) ◽  
pp. 1258-1261 ◽  
Author(s):  
Ivar Sønbø Kristiansen ◽  
Olav Helge Førde ◽  
Olaf Aasland ◽  
Ragnar Hotvedt ◽  
Roar Johnsen ◽  
...  
Keyword(s):  
Decision Making ◽  
Medical Decision Making ◽  
Randomised Trial ◽  
Medical Decision ◽  
Cross Sectional

scholarly journals The Impact of Pet Care Needs on Medical Decision-Making among Hospitalized Patients: A Cross-Sectional Analysis of Patient Experience

2021 ◽  
Vol 8 ◽  
pp. 237437352110460
Author(s):  
Carri S. Polick ◽  
Jennifer W. Applebaum ◽  
Caitlin Hanna ◽  
Darnysus Jackson ◽  
Sophia Tsaras-Schumacher ◽  
...  
Keyword(s):  
Decision Making ◽  
Medical Decision Making ◽  
Negative Impact ◽  
Care Center ◽  
Tertiary Care ◽  
Hospitalized Patients ◽  
Medical Decision ◽  
Care Needs ◽  
Cross Sectional ◽  
The Impact

Hospital-based protocols to support pet care needs for hospitalized patients may have potential to benefit patient health and wellbeing, but must be informed by experiences of hospitalized pet owners. The aim of this study was to determine the scope and need for pet care services among hospitalized patients. A panel of prior inpatients and their family members at a tertiary care center were surveyed about preferences, experiences, and need for assistance with pet care during hospitalization. Respondents (n = 113) expressed interest in a low/no-cost pet-boarding or foster program for adult patients struggling to find pet care assistance. The majority of respondents (n = 71; 63%) reported challenges securing pet care during a prior hospitalization, and/or knew someone who encountered similar challenges. Respondents also indicated that these challenges had a negative impact on health, recovery, or their own decision to receive medical care. Pet care challenges during hospitalization are likely common and have the potential to hamper medical decision-making and health outcomes of inpatients.

scholarly journals Relationship between trust and patient involvement in medical decision-making: A cross-sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256698
Author(s):  
Irina Pokhilenko ◽  
Thamar E. M. van Esch ◽  
Anne E. M. Brabers ◽  
Judith D. de Jong
Keyword(s):  
Decision Making ◽  
Patient Involvement ◽  
Medical Decision Making ◽  
Negative Relationship ◽  
Cross Sectional Study ◽  
Medical Decision ◽  
Cross Sectional ◽  
Dutch Health ◽  
Trust In Physicians ◽  
The Relationship

Introduction Patients vary in their preferences regarding involvement in medical decision-making. Current research does not provide complete explanation for this observed variation. Patient involvement in medical decision-making has been found to be influenced by various mechanisms, one of which could be patients’ trust in physicians. The aim of this study was to examine whether trust in physicians fosters or impairs patient involvement in medical decision-making. This study also aimed to determine to what extent the relationship between trust and preferences regarding decision-making roles was influenced by the sociodemographic characteristics of the patients. We hypothesised that trust can both foster and impair patient involvement in medical decision-making. Materials and methods A survey was sent out to members of the Nivel Dutch Health Care Consumer Panel in February 2016 (response rate = 47%, N = 703). The Wake Forest Physician Trust Scale was used to measure trust. Patient involvement was measured using two items based on the study published by Flynn and colleagues in 2006. Multiple regression analysis was used to analyse the relationship between trust and patient involvement. Results We found a negative relationship between trust and patient involvement in medical decision-making in men. Women with high trust reported to be more involved in medical decision-making compared to men with high trust. Conclusion The results suggest that trust impairs involvement in medical decision-making for men but not for women. Further research could provide a more comprehensive explanation of the variation in patient preferences regarding involvement in medical decision-making to further elucidate which underlying mechanisms could enhance patient participation.

scholarly journals Use of Tablets and Smartphones to Support Medical Decision Making in US Adults: Cross-Sectional Study (Preprint)

2020 ◽  
Author(s):  
Aisha Langford ◽  
Kerli Orellana ◽  
Jolaade Kalinowski ◽  
Carolyn Aird ◽  
Nancy Buderer
Keyword(s):  
Decision Making ◽  
Health Information ◽  
Medical Decision Making ◽  
Electronic Devices ◽  
Sociodemographic Factors ◽  
Medical Decision ◽  
Health And Wellness ◽  
Medical Decisions ◽  
Cross Sectional ◽  
Lower Odds

BACKGROUND Tablet and smartphone ownership have increased among US adults over the past decade. However, the degree to which people use mobile devices to help them make medical decisions remains unclear. OBJECTIVE The objective of this study is to explore factors associated with self-reported use of tablets or smartphones to support medical decision making in a nationally representative sample of US adults. METHODS Cross-sectional data from participants in the 2018 Health Information National Trends Survey (HINTS 5, Cycle 2) were evaluated. There were 3504 responses in the full HINTS 5 Cycle 2 data set; 2321 remained after eliminating respondents who did not have complete data for all the variables of interest. The primary outcome was use of a tablet or smartphone to help make a decision about how to treat an illness or condition. Sociodemographic factors including gender, race/ethnicity, and education were evaluated. Additionally, mobile health (mHealth)- and electronic health (eHealth)-related factors were evaluated including (1) the presence of health and wellness apps on a tablet or smartphone, (2) use of electronic devices other than tablets and smartphones to monitor health (eg, Fitbit, blood glucose monitor, and blood pressure monitor), and (3) whether people shared health information from an electronic monitoring device or smartphone with a health professional within the last 12 months. Descriptive and inferential statistics were conducted using SAS version 9.4. Weighted population estimates and standard errors, univariate odds ratios, and 95% CIs were calculated, comparing respondents who used tablets or smartphones to help make medical decisions (n=944) with those who did not (n=1377), separately for each factor. Factors of interest with a <i>P</i> value of &lt;.10 were included in a subsequent multivariable logistic regression model. RESULTS Compared with women, men had lower odds of reporting that a tablet or smartphone helped them make a medical decision. Respondents aged 75 and older also had lower odds of using a tablet or smartphone compared with younger respondents aged 18-34. By contrast, those who had health and wellness apps on tablets or smartphones, used other electronic devices to monitor health, and shared information from devices or smartphones with health care professionals had higher odds of reporting that tablets or smartphones helped them make a medical decision, compared with those who did not. CONCLUSIONS A limitation of this research is that information was not available regarding the specific health condition for which a tablet or smartphone helped people make a decision or the type of decision made (eg, surgery, medication changes). In US adults, mHealth and eHealth use, and also certain sociodemographic factors are associated with using tablets or smartphones to support medical decision making. Findings from this study may inform future mHealth and other digital health interventions designed to support medical decision making.

scholarly journals Trauma Patients' Desire for Autonomy in Medical Decision Making is Impaired by Smoking and Hazardous Alcohol Consumption – a Bi-national Study

2007 ◽  
Vol 35 (5) ◽  
pp. 609-614 ◽  
Author(s):  
B Neuner ◽  
A Dizner-Golab ◽  
LM Gentilello ◽  
B Habrat ◽  
E Mayzner-Zawadzka ◽  
...  
Keyword(s):  
Decision Making ◽  
Substance Use ◽  
Alcohol Consumption ◽  
Medical Decision Making ◽  
Medical Decision ◽  
National Study ◽  
Trauma Patients ◽  
Cross Sectional ◽  
Hazardous Alcohol ◽  
Hazardous Alcohol Consumption

This cross-sectional investigation studied the association between substance use and patients' desire for autonomy in medical decision making (MDM) in two trauma settings. A total of 102 patients (age 42.7 ≤ 17.4 years, 70.6% male) admitted to an orthopaedic service in Warsaw, Poland, and 1009 injured patients (age 34.6 ≤ 12.8 years, 62.3% male) treated in an emergency department in Berlin, Germany, were enrolled. Patients' desire for autonomy in MDM was evaluated with the Decision Making Preference Scale of the Autonomy Preference Index. Substance use (hazardous alcohol consumption and/or tobacco use) and educational level were measured. Linear regression techniques were used to determine the association between substance use and desire for autonomy in MDM. Substance use was found to be independently associated with a reduced desire by the patient for autonomy in medical decision making. No differences in patients' desire for autonomy were observed between the study sites. Empowerment strategies that encourage smokers or patients with hazardous alcohol consumption to participate in MDM may increase the effectiveness of health promotion and injury prevention efforts in this population.

scholarly journals An Emergency Medical Triage Tool for Swiftwater Rescue

2019 ◽  
Vol 34 (s1) ◽  
pp. s125-s126 ◽  
Author(s):  
David Jaslow ◽  
Nathaniel Zahustecher ◽  
Fred Ellinger ◽  
Derek Zecher ◽  
Ryan Overberger
Keyword(s):  
Decision Making ◽  
Medical Decision Making ◽  
Vital Signs ◽  
Psychological Trauma ◽  
Skin Lesions ◽  
Flow Diagram ◽  
Medical Decision ◽  
Medical Screening ◽  
Cross Sectional ◽  
Emergency Medical

Introduction:Climate change and overdevelopment increase the intensity and frequency of flash flooding, which may generate more swiftwater rescue (SWR) incidents. Rescue personnel may fail to properly risk stratify (triage) these victims due to limited medical and/or variable SWR training, or due to an adverse rescuer-to-victim ratio. Some victims may attempt to refuse medical evaluation due to lack of awareness of incident-related morbidity and/or comprehension of risk.Aim:To develop an SWR emergency medical triage tool.Methods:A cross-sectional literature search identified SWR-related medical conditions. A flow diagram reliant upon incident history, chief complaint, and observational exam rather than interpretation of vital signs was created to guide medical decision-making.Results:Every SWR victim should receive a medical screening exam focused on six clinical categories—drowning, hypothermia, hazmat exposure, physical trauma, psychological trauma and exacerbation of pre-existing disease. Drowning potential is identified by dyspnea, new cough or a history of (even brief) submersion. Shivering SWR victims and those with altered mental status but no shivering are assumed to be hypothermic. Any victim with open skin lesions/wounds who was immersed in floodwater and anyone who has swallowed floodwater is contaminated; these victims require decontamination and possible antibiotic therapy. SWR victims injured upon entering the water or from contact with either water-borne stationary or floating objects require trauma evaluation. Distraught victims and those who exhibit exacerbation of pre-existing organ-system disease also require ED evaluation.Discussion:Most SWR course curricula are oriented towards technical rescue; they do not address comprehensive medical decision-making. We present a rapid medical screening exam designed to determine which SWR victims require an ED evaluation. Such a triage tool will assist rescuers to simultaneously honor patient autonomy and avoid risky and uninformed refusal of medical aid. Simplified medical decision-making should enable the application of this tool worldwide.

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