Supplemental Material for Couples’ Treatment Preferences for Insomnia Experienced During Pregnancy

Denial and dissociation are analytic constructs that indicate the presence of overwhelming affect. Trauma studies and neuroscience research offer important contributions that can expand and reinforce an analytic approach to these dynamics in couples. Through focusing on emotional memories, emotional regulation, and countertransference, the therapist may become more aware and comfortable with this work.

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The impact of a physician’s recommendation and gender on informed decision making: A randomized controlled study in a simulated decision situation

10.31234/osf.io/r5vg4 ◽

2020 ◽

Cited By ~ 1

Author(s):

Marie Eggeling ◽

Anna Meinhardt ◽

Ulrike Cress ◽

Joachim Kimmerle ◽

Martina Bientzle

Keyword(s):

Decision Making ◽

Cruciate Ligament ◽

Treatment Options ◽

General Information ◽

Treatment Preference ◽

Controlled Study ◽

Treatment Preferences ◽

Hypothetical Scenario ◽

And Gender ◽

The Impact

Objective: This study examined the influence of physicians’ recommendations and gender on the decision-making process in a preference-sensitive situation. Methods: N = 201 participants were put in a hypothetical scenario in which they suffered from a rupture of the anterior cruciate ligament (ACL). They received general information on two equally successful treatment options for this injury (surgery vs. physiotherapy) and answered questions regarding their treatment preference, certainty and satisfaction regarding their decision, and attitude toward the treatment options. Then participants watched a video that differed regarding physician’s recommendation (surgery vs. physiotherapy) and physician’s gender (female vs. male voice and picture). Afterward, they indicated again their treatment preference, certainty, satisfaction, and attitude, as well as the physician’s professional and social competence.Results: Participants changed their treatment preferences in the direction of the physician’s recommendation (P<.001). Decision certainty (P<.001) and satisfaction (P<.001) increased more strongly if the physician’s recommendation was congruent with the participant’s prior attitude than if the recommendation was contrary to the participant’s prior attitude. Finally, participants’ attitudes toward the recommended treatment became more positive (surgery recommendation: P<.001; physiotherapy recommendation: P<.001). We found no influence of the physician’s gender on participants’ decisions, attitudes, or competence assessments.Conclusion: This research indicates that physicians should be careful with recommendations when aiming for shared decisions, as they might influence patients even if the patients have been made aware that they should take their personal preferences into account. This could be particularly problematic if the recommendation is not in line with the patient’s preferences.

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Medical and Nonmedical Information during Multidisciplinary Team Meetings in Cancer Care

Current Oncology ◽

10.3390/curroncol28010098 ◽

2021 ◽

Vol 28 (1) ◽

pp. 1008-1016

Author(s):

Jessica Wihl ◽

Linn Rosell ◽

Tobias Carlsson ◽

Sara Kinhult ◽

Gert Lindell ◽

...

Keyword(s):

Decision Making ◽

Multidisciplinary Team ◽

Cancer Care ◽

Family Relations ◽

Patient Characteristics ◽

Psychological Status ◽

Treatment Preferences ◽

Case Discussions ◽

Case Presentations ◽

Data Elements

Background: Multidisciplinary team (MDT) meetings provide treatment recommendations based on available information and collective decision-making in teams with complementary professions, disciplines and skills. We aimed to map ancillary medical and nonmedical patient information during case presentations and case discussions in MDT meetings in cancer care. Methods: Through a nonparticipant, observational approach, we mapped verbal information on medical, nonmedical and patient-related characteristics and classified these based on content. Data were collected from 336 case discussions in three MDTs for neuro-oncology, sarcoma and hepato-biliary cancer. Results: Information on physical status was presented in 48.2% of the case discussions, psychological status in 8.9% and comorbidity in 48.5% of the cases. Nonmedical factors, such as family relations, occupation, country of origin and abode were referred to in 3.6–7.7% of the cases, and patient preferences were reported in 4.2%. Conclusions: Provision of information on comorbidities in half of the cases and on patient characteristics and treatment preferences in <10% of case discussions suggest a need to define data elements and develop reporting standards to support robust MDT decision-making.

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Variation in treatment preferences of pulmonary exacerbations among Australian and New Zealand cystic fibrosis physicians

BMJ Open Respiratory Research ◽

10.1136/bmjresp-2021-000956 ◽

2021 ◽

Vol 8 (1) ◽

pp. e000956

Author(s):

Grace Currie ◽

Anna Tai ◽

Tom Snelling ◽

André Schultz

Keyword(s):

Cystic Fibrosis ◽

Clinical Trials ◽

New Zealand ◽

Treatment Options ◽

Early Response ◽

Treatment Preferences ◽

Dornase Alfa ◽

Clinical Scenarios ◽

Professional Opinion ◽

Pulmonary Exacerbations

BackgroundDespite advances in cystic fibrosis (CF) management and survival, the optimal treatment of pulmonary exacerbations remains unclear. Understanding the variability in treatment approaches among physicians might help prioritise clinical uncertainties to address through clinical trials.MethodsPhysicians from Australia and New Zealand who care for people with CF were invited to participate in a web survey of treatment preferences for CF pulmonary exacerbations. Six typical clinical scenarios were presented; three to paediatric and another three to adult physicians. For each scenario, physicians were asked to choose treatment options and provide reasons for their choices.ResultsForty-nine CF physicians (31 paediatric and 18 adult medicine) participated; more than half reported 10+ years of experience. There was considerable variation in primary antibiotic selection; none was preferred by more than half of respondents in any scenario. For secondary antibiotic therapy, respondents consistently preferred intravenous tobramycin and a third antibiotic was rarely prescribed, except in one scenario describing an adult patient. Hypertonic saline nebulisation and twice daily chest physiotherapy was preferred in most scenarios while dornase alfa use was more variable. Most CF physicians (>80%) preferred to change therapy if there was no early response. Professional opinion was the most common reason for antibiotic choice.ConclusionsVariation exists among CF physicians in their preferred choice of primary antibiotic and use of dornase alfa. These preferences are driven by professional opinion, possibly reflecting a lack of evidence to base policy recommendations. Evidence from high-quality clinical trials is needed to inform physician decision making.

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Ethnic differences in treatment preferences among adults in East London

BDJ ◽

10.1038/s41415-020-2597-0 ◽

2021 ◽

Author(s):

Sanober Naz ◽

Eduardo Bernabe ◽

Wagner Marcenes ◽

Elsa Karina Delgado-Angulo

Keyword(s):

Ethnic Differences ◽

Treatment Preferences

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Internet search and medicaid prescription drug data as predictors of opioid emergency department visits

npj Digital Medicine ◽

10.1038/s41746-021-00392-w ◽

2021 ◽

Vol 4 (1) ◽

Author(s):

Sean D. Young ◽

Qingpeng Zhang ◽

Jiandong Zhou ◽

Rosalie Liccardo Pacula

Keyword(s):

Emergency Department ◽

Prescription Drug ◽

Drug Utilization ◽

Prediction Models ◽

Emergency Department Visits ◽

Treatment Preferences ◽

Internet Search ◽

Utilization Data ◽

Ed Visits ◽

Medicaid Prescription

AbstractThe primary contributors to the opioid crisis continue to rapidly evolve both geographically and temporally, hampering the ability to halt the growing epidemic. To address this issue, we evaluated whether integration of near real-time social/behavioral (i.e., Google Trends) and traditional health care (i.e., Medicaid prescription drug utilization) data might predict geographic and longitudinal trends in opioid-related Emergency Department (ED) visits. From January 2005 through December 2015, we collected quarterly State Drug Utilization Data; opioid-related internet search terms/phrases; and opioid-related ED visit data. Modeling was conducted using least absolute shrinkage and selection operator (LASSO) regression prediction. Models combining Google and Medicaid variables were a better fit and more accurate (R2 values from 0.913 to 0.960, across states) than models using either data source alone. The combined model predicted sharp and state-specific changes in ED visits during the post 2013 transition from heroin to fentanyl. Models integrating internet search and drug utilization data might inform policy efforts about regional medical treatment preferences and needs.

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