What Patients and Families Want to Know About Hospice (DRAFT)

2018 ◽  
Author(s):  
Regina Mackey ◽  
Kimberson Tanco
Keyword(s):  
Decision Making ◽  
Family Caregivers ◽  
Clinical Case ◽  
Decision Making Process ◽  
Advanced Illness ◽  
Initial Information ◽  
Dying Patients ◽  
Hospice Patients ◽  
The Family ◽  
Gain Access

Hospice services are widely used in the care of dying patients. With hospice, patients and their families gain access to various benefits and services. However, the decision to enroll into hospice can be difficult for patients with advanced illness and also the family caregivers. This study explores the hospice decision-making process and how the enrollment decision is shared between patients and their families. This study also explores the knowledge of hospice at the time of initial information visit and the patients’ and families’ priorities for information. The chapter also briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case.

Prenatal Genetic Diagnosis for Pediatricians

PEDIATRICS ◽  
1994 ◽  
Vol 93 (6) ◽  
pp. 1010-1015
Author(s):  
Keyword(s):  
Decision Making ◽  
Genetic Counseling ◽  
Prenatal Diagnosis ◽  
Diagnostic Tests ◽  
Genetic Disorder ◽  
Genetic Diagnosis ◽  
Decision Making Process ◽  
Know How ◽  
Prenatal Genetic Diagnosis ◽  
The Family

Pediatricians may be called upon to counsel a family in which prenatal diagnosis is being considered or in which there is a fetus with a genetic disorder. In some settings, the pediatrician may be the primary resource for counseling the family. More frequently, counseling may already have been provided by a clinical geneticist and/or obstetrician. However, because of a previous relationship with the family, the pediatrician may be called upon to review this information and to assist the family in the decision-making process. The pediatrician should be familiar with the principles of prenatal genetic diagnosis and know how to apply them to specific problems in genetic counseling, diagnosis, and management in clinical practice. At the same time, pediatricians should be familiar with resources available in their region for obtaining information about whether and how a specific disorder can be diagnosed and when and where to refer patients for prenatal genetic diagnosis. The technology of prenatal diagnosis is changing rapidly, and genetic consultants can assist pediatricians in the appropriate utilization and interpretation of the diagnostic tests that are available.

scholarly journals Mapping and understanding the decision-making process for providing nutrition and hydration to people living with dementia: a systematic review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Kanthee Anantapong ◽  
Nathan Davies ◽  
Justin Chan ◽  
Daisy McInnerney ◽  
Elizabeth L. Sampson
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Family Caregivers ◽  
Case Studies ◽  
Tube Feeding ◽  
Oral Feeding ◽  
Cochrane Library ◽  
Decision Making Process ◽  
Final Decision ◽  
Nutrition And Hydration

Abstract Background This systematic review aimed to explore the process of decision-making for nutrition and hydration for people living with dementia from the perspectives and experiences of all involved. Methods We searched CINAHL, the Cochrane Library, EMBASE, MEDLINE and PsycINFO databases. Search terms were related to dementia, decision-making, nutrition and hydration. Qualitative, quantitative and case studies that focused on decision-making about nutrition and hydration for people living with dementia were included. The CASP and Murad tools were used to appraise the quality of included studies. Data extraction was guided by the Interprofessional Shared Decision Making (IP-SDM) model. We conducted a narrative synthesis using thematic analysis. PROSPERO registration number CRD42019131497. Results Forty-five studies were included (20 qualitative, 15 quantitative and 10 case studies), comprising data from 17 countries and 6020 patients, family caregivers and practitioners. The studies covered a range of decisions from managing oral feeding to the use of tube feeding. We found that decisions about nutrition and hydration for people living with dementia were generally too complex to be mapped onto the precise linear steps of the existing decision-making model. Decision-making processes around feeding for people living with dementia were largely influenced by medical evidence, personal values, cultures and organizational routine. Although the process involved multiple people, family caregivers and non-physician practitioners were often excluded in making a final decision. Upon disagreement, nutrition interventions were sometimes delivered with conflicting feelings concealed by family caregivers or practitioners. Most conflicts and negative feelings were resolved by good relationship, honest communication, multidisciplinary team meetings and renegotiation. Conclusions The decision-making process regarding nutrition and hydration for people living with dementia does not follow a linear process. It needs an informed, value-sensitive, and collaborative process. However, it often characterized by unclear procedures and with a lack of support. Decisional support is needed and should be approached in a shared and stepwise manner.

Treatment decision-making for older adults with cancer: A qualitative study

2020 ◽  
pp. 096973302094575
Author(s):  
Ni Gong ◽  
Qianqian Du ◽  
Hongyu Lou ◽  
Yiheng Zhang ◽  
Hengying Fang ◽  
...  
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Cancer Patients ◽  
Family Members ◽  
Treatment Decision ◽  
Chinese Society ◽  
Decision Making Process ◽  
Treatment Decision Making ◽  
The Family ◽  
Older Cancer Patients

Background: Independent decision-making is one of the basic rights of patients. However, in clinical practice, most older cancer patients’ treatment decisions are made by family members. Objective: This study attempted to analyze the treatment decision-making process and formation mechanism for older cancer patients within the special cultural context of Chinese medical practice. Method: A qualitative study was conducted. With the sample saturation principle, data collected by in-depth interviews with 17 family members and 12 patients were subjected to thematic analysis. Ethical considerations: The study was approved by the ethics committees of Sun Yat-sen University. All participants provided verbal informed consent after being told their rights of confidentiality, anonymity, and voluntary participation. They had the right to refuse to answer questions and could withdraw at any time. Results: Three themes emerged: (1) complex process; (2) transformation of family decision-making power; and (3) individual compromise. Family members inevitably had different opinions during the long process of treatment decision-making for older cancer patients. The direction of this process could be regarded as an extension of the family power relationship. The patient usually compromised the decision to survive, which was made by family members. Conclusion: This study describes the treatment decision-making process of older cancer patients in the context of Chinese culture. The reasons underlying this process are related to the views on life and death and family values. An individual is a part of the family, which is often seen as the minimal interpersonal unit in Chinese society. It is significant that while emphasizing patient autonomy in the decision-making process, health professionals should also pay attention to the important roles of culture and family.

Family involvement in the end-of-life decisions of competent intensive care patients

2012 ◽  
Vol 20 (1) ◽  
pp. 61-71 ◽  
Author(s):  
Ranveig Lind ◽  
Per Nortvedt ◽  
Geir Lorem ◽  
Olav Hevrøy
Keyword(s):  
Decision Making ◽  
Intensive Care ◽  
End Of Life ◽  
Family Involvement ◽  
Decision Making Process ◽  
Primary Role ◽  
Her Family ◽  
Intensive Care Patients ◽  
The Family ◽  
End Of Life Decision

In this article, we report the findings from a qualitative study that explored how relatives of terminally ill, alert and competent intensive care patients perceived their involvement in the end-of-life decision-making process. Eleven family members of six deceased patients were interviewed. Our findings reveal that relatives narrate about a strong intertwinement with the patient. They experienced the patients’ personal individuality as a fragile achievement. Therefore, they viewed their presence as crucial with their primary role to support and protect the patient, thereby safeguarding his values and interests. However, their inclusion in decision making varied from active participation in the decision-making process to acceptance of the physicians’ decision or just receiving information. We conclude that models of informed shared decision making should be utilised and optimised in intensive care, where nurses and physicians work with both the patient and his or her family and regard the family as partners in the process.

scholarly journals Influence of children in real estate family purchase decision-making context

2020 ◽  
Vol 18 (3) ◽  
pp. 211-217
Author(s):  
I. Kancheva
Keyword(s):  
Decision Making ◽  
Real Estate ◽  
Purchase Decision ◽  
Decision Making Process ◽  
Final Phase ◽  
Convenience Sample ◽  
Frequency Distributions ◽  
The Real Estate ◽  
Paired Samples ◽  
The Family

Purpose: Children play a significant role as active participants in different markets through their own spending power. They are also able to exert considerable influence – explicit or implicit - over other family members’ consumer behavior. The combination of various spatial, structural, financial and practical aspects place the purchase of a real estate among the most complex for the family. The objective of the present paper is to reveal the degree and form of children’s influence throughout family real estate purchase decision-making process. Methods: This paper represents the results of an empirical study focused on parental perceptions of children’s influence in a family real estate purchase. Data were gathered using a convenience sample of 286 respondents – 156 men and 130 women from different Bulgarian families. Frequency distributions, analysis of variance, paired samples and independent samples t-test were applied for the aims of the analysis. Results: Children are found to exert moderate indirect influence throughout the family real estate purchase. They are most influential in the final phase of the real estate purchase decision-making process. Although high influence scores are detected in some attributive decisions, children are found least influential over choices related to technical and financial aspects of the purchase.

scholarly journals Women and the Family in Lebanon: Figures and Facts

1970 ◽  
pp. 9-10
Author(s):  
Hassan Hammoud
Keyword(s):  
Decision Making ◽  
Development Program ◽  
Decision Making Process ◽  
United Nations Development Program ◽  
Occupational Characteristics ◽  
The Family ◽  
The Status ◽  
Post War ◽  
First Time ◽  
Nations Development

In collaboration with the United Nations Development Program, the Lebanese Ministry of Social Affairs has completed a survey ' that provides for the first time in 65 years a comprehensive profile of the population in post-war Lebanon. One of its several objectives was to identify the demographic, educational, social, and occupational characteristics of Lebanese society. If properly considered, such information could play a major role in the decision-making process over several public policies in the country. The data of the survey are presented in 187 statistical tables . I will analyse selected tables related to the status and characteristics of women and the family.

scholarly journals Developing Skills for Youthful Leaders Module 6: Making a Decision

EDIS ◽  
2006 ◽  
Vol 2006 (9) ◽  
Author(s):  
Elizabeth B. Bolton ◽  
John R. Rutledge ◽  
Linda Bowman ◽  
Linda Barber
Keyword(s):  
Decision Making ◽  
Everyday Life ◽  
Decision Making Process ◽  
Publication Date ◽  
The Family

The objectives of this lesson are to learn the importance of decision making in everyday life, to learn a process for making decisions, and to use the decision making process. This document is FCS9093, one of a series of the Family Youth and Community Sciences Department, UF/IFAS Extension. EDIS publication date May 2006. 

Clinicians’ moral distress and family satisfaction in the intensive care unit

2018 ◽  
Vol 25 (12) ◽  
pp. 1894-1904 ◽  
Author(s):  
Giulia Lamiani ◽  
Matteo Ciconali ◽  
Piergiorgio Argentero ◽  
Elena Vegni
Keyword(s):  
Decision Making ◽  
Intensive Care ◽  
Emotional Support ◽  
Moral Distress ◽  
Family Satisfaction ◽  
Satisfaction With Care ◽  
Decision Making Process ◽  
The Family ◽  
Distress Scale ◽  
The Relationship

This study explored the relationship between clinicians’ moral distress and family satisfaction with care in five intensive care units in Italy. A total of 122 clinicians (45 physicians and 77 nurses) and 59 family members completed the Italian Moral Distress Scale-Revised and the Family Satisfaction in the ICU questionnaire, respectively. Clinicians’ moral distress inversely correlated with family satisfaction related to the inclusion in the decision-making process. Specifically, physicians’ moral distress inversely correlated with satisfaction regarding the respect shown toward the patient. Nurses’ moral distress inversely correlated with satisfaction regarding breathlessness and agitation management, provision of emotional support, understanding of information, and inclusion in the decision-making process.

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