Treatment Decision Making

2021 ◽  
pp. 573-577
Author(s):  
Allison Marziliano ◽  
Michael A. Diefenbach
Keyword(s):  
Decision Making ◽  
Cultural Differences ◽  
Gold Standard ◽  
Ethnic Disparities ◽  
Treatment Decision ◽  
Optimal Treatment ◽  
Future Research ◽  
Decision Tools ◽  
Treatment Decision Making ◽  
Racial Ethnic

This chapter focuses on the different facets of treatment decision making that have been empirically derived and are part of the peer-reviewed literature. These facets are approaches of treatment decision making (i.e. exploration and uptake of shared decision making, the current gold standard of treatment decision making); optimal treatment decision making (i.e. barriers and facilitators to engaging in optimal treatment decision making); support for treatment decision making (i.e. decision tools, nomograms, and seeking guidance on the Internet); the psychosocial state of patients following treatment decisions; and considerations related to studying treatment decision making (i.e. racial/ethnic disparities, cultural differences in decision making). Areas in which research is lacking or nonexistent (i.e. ensuring the patient understands the goals of treatment before making a treatment decision) are also highlighted as directions for future research.

Key elements of optimal treatment decision-making for surgeons and older patients with colorectal or pancreatic cancer: A qualitative study

2017 ◽  
Vol 100 (3) ◽  
pp. 473-479 ◽  
Author(s):  
Noralie H. Geessink ◽  
Yvonne Schoon ◽  
Hanneke C.P. van Herk ◽  
Harry van Goor ◽  
Marcel G.M. Olde Rikkert
Keyword(s):  
Pancreatic Cancer ◽  
Decision Making ◽  
Qualitative Study ◽  
Older Patients ◽  
Treatment Decision ◽  
Optimal Treatment ◽  
Treatment Decision Making

scholarly journals Exploring the Experiences of Adults With Microtia: A Qualitative Study

2020 ◽  
Vol 57 (10) ◽  
pp. 1230-1237
Author(s):  
Claire Hamlet ◽  
Diana Harcourt
Keyword(s):  
Decision Making ◽  
Negative Impact ◽  
Treatment Decision ◽  
Improve Patient Care ◽  
Psychosocial Interventions ◽  
Romantic Partners ◽  
Future Research ◽  
Ear Reconstruction ◽  
Structured Interviews ◽  
Treatment Decision Making

Objective: Microtia is a medically complex condition, with the option of surgery to address hearing and reconstruct the ear. The current study explored adults’ experiences of microtia, with a particular focus on the psychosocial impact and experiences of ear reconstruction. The ultimate aim was to identify areas for support and future research that could improve patient care. Design: Fifteen adults (12 females) aged between 20 and 62 years took part in semi-structured interviews. Interviews were audio-recorded, transcribed verbatim, and analyzed using inductive thematic analysis. Results: Three main themes were identified in the data: microtia as an invisible difference, surgery as a welcome opportunity, and living well with microtia. Participants had incorporated microtia into their self-concept and did not report a lasting negative impact on their lives. However, some psychosocial challenges were reported, including anxiety about showing their ears (even after reconstruction), disclosing their diagnosis to romantic partners, surgical decision-making, and feeling unsupported in the work environment. Conclusion: Individuals with microtia may benefit from psychosocial interventions to increase confidence, access to support for treatment decision-making, and guidance around disclosing microtia to employers.

scholarly journals Patients' priorities for treatment decision making during periods of incapacity: quantitative survey

2014 ◽  
Vol 13 (5) ◽  
pp. 1165-1183 ◽  
Author(s):  
Annette Rid ◽  
Robert Wesley ◽  
Mark Pavlick ◽  
Sharon Maynard ◽  
Katalin Roth ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Financial Burden ◽  
Care Center ◽  
Tertiary Care ◽  
Treatment Decision ◽  
Treatment Decisions ◽  
Future Research ◽  
Quantitative Survey ◽  
Treatment Decision Making

AbstractObjective:Clinical practice aims to respect patient autonomy by basing treatment decisions for incapacitated patients on their own preferences. Yet many patients do not complete an advance directive, and those who do frequently just designate a family member to make decisions for them. This finding raises the concern that clinical practice may be based on a mistaken understanding of patient priorities. The present study aimed to collect systematic data on how patients prioritize the goals of treatment decision making.Method:We employed a self-administered, quantitative survey of patients in a tertiary care center.Results:Some 80% or more of the 1169 respondents (response rate = 59.8%) ranked six of eight listed goals for treatment decision making as important. When asked which goal was most important, 38.8% identified obtaining desired or avoiding unwanted treatments, 20.0% identified minimizing stress or financial burden on their family, and 14.6% identified having their family help to make treatment decisions. No single goal was designated as most important by 25.0% of participants.Significance of Results:Patients endorsed three primary goals with respect to decision making during periods of incapacity: being treated consistent with their own preferences; minimizing the burden on their family; and involving their family in the decision-making process. However, no single goal was prioritized by a clear majority of patients. These findings suggest that advance care planning should not be limited to documenting patients' treatment preferences. Clinicians should also discuss and document patients' priorities for how decisions are to be made. Moreover, future research should evaluate ways to modify current practice to promote all three of patients primary goals for treatment decision making.

Patients’ practices for taking the initiative in decision-making in outpatient psychiatric consultations

2017 ◽  
Vol 13 (2) ◽  
pp. 169-184 ◽  
Author(s):  
Shuya Kushida ◽  
Takeshi Hiramoto ◽  
Yuriko Yamakawa
Keyword(s):  
Decision Making ◽  
Conversation Analysis ◽  
Treatment Decision ◽  
Close Inspection ◽  
Important Resource ◽  
Treatment Decision Making ◽  
The Way

In spite of increasing advocacy for patients’ participation in psychiatric decision-making, there has been little research on how patients actually participate in decision-making in psychiatric consultations. This study explores how patients take the initiative in decision-making over treatment in outpatient psychiatric consultations in Japan. Using the methodology of conversation analysis, we analyze 85 video-recorded ongoing consultations and find that patients select between two practices for taking the initiative in decision-making: making explicit requests for a treatment and displaying interest in a treatment without explicitly requesting it. A close inspection of transcribed interaction reveals that patients make explicit requests under the circumstances where they believe the candidate treatment is appropriate for their condition, whereas they merely display interest in a treatment when they are not certain about its appropriateness. By fitting practices to take the initiative in decision-making with the way they describe their current condition, patients are optimally managing their desire for particular treatments and the validity of their initiative actions. In conclusion, we argue that the orderly use of the two practices is one important resource for patients’ participation in treatment decision-making.

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