scholarly journals Personal Identity and Patient-Centered Medical Decision Making

2017 ◽  
Vol 8 (3) ◽  
pp. 194-195
Author(s):  
Lucie White
Keyword(s):  
Decision Making ◽  
Personal Identity ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Patient Centered

Medical decision making: paternalism versus patient-centered (autonomous) care

2008 ◽  
Vol 14 (6) ◽  
pp. 708-713 ◽  
Author(s):  
Carlos A Rodriguez-Osorio ◽  
Guillermo Dominguez-Cherit
Keyword(s):  
Decision Making ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Patient Centered

Patient-reported satisfaction with reconstructed breasts in the long-term survivorship period: Comparison of autologous and nonautologous breast reconstruction.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9043-9043 ◽  
Author(s):  
Amie Scott ◽  
Adelyn Ho ◽  
Anne Klassen ◽  
Stefan Cano ◽  
Nancy VanLaeken ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Patient Satisfaction ◽  
Breast Reconstruction ◽  
Medical Decision Making ◽  
Univariate Analysis ◽  
Medical Decision ◽  
Patient Centered ◽  
Patient Reported ◽  
Type Of Surgery

9043 Background: Breast cancer patients undergoing mastectomy may choose to have reconstruction performed using either their own tissue or an implant. As many patients are candidates for both, valid and reliable patient-centered outcomes data are crucial to shared medical decision-making. The objective of this study is to determine whether patient-reported satisfaction with their reconstructed breasts is dependent on type of reconstructive surgery and length of time from reconstruction. Methods: Participants were recruited from Memorial Sloan-Kettering Cancer, NY and the University of British Columbia, Canada. Patients completed the BREAST-Q, a new patient-reported outcome measure for breast surgery patients. The dependent variable was the BREAST-Q Satisfaction with Breast score, a 16-item scale scored from 0-100. Procedure type, time since surgery, and patient characteristics were independent variables. Univariate analysis and clinical judgment were used to identify variables included in the model, and multivariate linear regression models were constructed to control for confounders. Results: The study sample consisted of 510 women (response rate 62%). The sample was on average aged 54.3 ± 9.3 (range 21-81), surveyed 3.71 years ± 1.55 (range 1-9) after surgery, 66% were reconstructed using an implant. Type of surgery and laterality were found to be variables that predicted higher patient satisfaction with their breasts after controlling for radiation therapy, follow-up time, timing of surgery, age, body mass index, and major complications (surgery type p<0.001; laterality p<0.001, R-square=0.17). Conclusions: As there is a growing population of breast cancer survivors, understanding how a woman’s satisfaction with her reconstructed breasts changes over time is essential. This study suggests that patient satisfaction with breast reconstruction depends on the type of reconstruction a woman undergoes. This patient-centered outcome data can be used to enhance shared medical decision-making by providing patients with information about realistic expectations for satisfaction with breasts related to type of surgery chosen.

scholarly journals Trusted person with elderly patients in France: protocol of a scoping review

2021 ◽  
Author(s):  
Luigi Gontard ◽  
Maïva Ropaul
Keyword(s):  
Decision Making ◽  
Elderly Patients ◽  
End Of Life ◽  
Health Professionals ◽  
Medical Decision Making ◽  
Selection Process ◽  
Medical Decision ◽  
Patient Centered ◽  
Fin De Vie ◽  
Family Centered

Background: The background of this study is the recent adoption and updates of surrogate medical decision making in France. The legal designation of a trusted person, meant to ensure that the patient's wishes are made known, has first been introduced in France by the 2002 law on the rights of the sick and the quality of the health system (also known as “Kouchner law”). Some updates came later with the 2005 law relative to patient’s rights and end of life (« Leonetti law ») and the 2016 law on the rights of persons at the end of life (« Claeys-Leonetti law »). The study addresses the question of the effectiveness and challenges of this system in the French context.Objective: The review was guided by the question: “what is the extent of research in France on patient-centered, family-centered and health professionals-centered outcomes associated with the trusted person system, when elderly patients are involved?”. The aims are to measure the extent of the research on surrogate medical decision-making research in France for elderly patients, how well all subpopulations are represented, the methodologies used and whether they are sufficient in describing patient-centered, family-centered and health professionals-centered outcomes associated with surrogate medical decision-making.Searches: We used 11 scientific databases in order to conduct our research: PubMed, ScienceDirect, EconLit, CINHAL Plus, Embase, LISSA, Cairn.info, the Bibliothèque numérique de droit de la santé et d'éthique médicale (BNDS), the Banque de données en santé publique (BDSP), the Catalogue et index des sites médicaux de langue française (CISMEF) and the Plateforme nationale pour la recherche sur la fin de vie (PNRFV).Types of study to be included: Quantitative, qualitative, and mixed-method studies were included in order to consider different aspects of research and data collection on surrogate medical decision making.Design: Online databases were used to identify papers published during the period 2002-2021, from which we have selected publications written in French or English, applying our search strategies. Flow chart describing the selection process: See the PDFResults: No progress on this item at this time.Conclusions: No progress on this item at this time.

Role of religiosity in medical decision making among patients with colorectal cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9579-9579
Author(s):  
Mosmi Surati ◽  
Rachel Davis ◽  
Sarah T. Hawley ◽  
Paul Abrahamse ◽  
Kevin C. Ward ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Decision Making ◽  
Adjuvant Chemotherapy ◽  
Medical Decision Making ◽  
Population Based ◽  
Medical Decision ◽  
Patient Centered ◽  
Level Of Involvement ◽  
Physician Trust ◽  
Trust In Physicians

9579 Background: Physician-based medical decision making (DM) has declined in favor of more patient-centered approaches. Most studies indicate that patients want to be involved; however, the level of desired involvement varies between patients wanting to make their own decisions and those preferring to leave decisions to physicians. Little is known of the factors associated with DM preferences. Given data demonstrating the influence of religion among cancer patients, we explored religiosity and decision making preferences in colorectal cancer (CRC) patients. Methods: We surveyed a population-based cohort of Stage III CRC patients from the Detroit and Georgia SEER registries. Patients were queried about desired level of involvement in DM, trust in physicians, religiosity, receipt of adjuvant chemotherapy, and demographics. Religiosity was assessed using the Holland System of Belief Inventory. Physician trust was assessed using the Wake Forest Physician Trust scale. Responses were collected along a Likert scale and results were dichotomized. Surveys were analyzed using univariate and bivariate methods. Results: Thus far, 430 CRC patients have responded (56% response rate). The median participant age is 61 years, 45% are female, and 19% are black. 54% indicated a preference for shared DM, 35% prefer “doctors to make [their] decisions”, and 11% prefer to “make [their] own decisions”. The distribution did not differ by age, gender, race, income, or level of education. Higher religiosity was associated with higher trust in the surgeon (p=0.007) but not the oncologist (p=0.3). Patients with higher religiosity scores and higher physician trust were more likely to prefer that their doctors make the decisions (p= 0.023, p<0.001). Preference for physician DM was associated with higher receipt of adjuvant chemotherapy (p=0.002). Conclusions: Patients who were more religious preferred to leave medical DM to physicians. Those who relied on physician DM were more likely to receive chemotherapy. This association may be mediated through higher trust. Understanding the influence of religiosity may be a tool to help providers get their patients appropriate cancer care.

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