scholarly journals Decision making processes in people with symptoms of acute myocardial infarction: qualitative study

BMJ ◽  
2002 ◽  
Vol 324 (7344) ◽  
pp. 1006-1006 ◽  
Author(s):  
J. Pattenden
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Decision Making ◽  
Qualitative Study ◽  
Decision Making Processes

scholarly journals Decision-making dilemmas of paediatricians: a qualitative study in Japan

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e026579
Author(s):  
Momoko Sasazuki ◽  
Yasunari Sakai ◽  
Ryutaro Kira ◽  
Naoko Toda ◽  
Yuko Ichimiya ◽  
...  
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Professional Education ◽  
Best Interests ◽  
Complex Structures ◽  
Social Consensus ◽  
Face To Face ◽  
Life Threatening ◽  
Decision Making Processes ◽  
Five Elements

ObjectiveTo delineate the critical decision-making processes that paediatricians apply when treating children with life-threatening conditions and the psychosocial experience of paediatricians involved in such care.DesignWe conducted semistructured, individual face-to-face interviews for each participant from 2014 to 2015. The content of each interview was subjected to a comprehensive qualitative analysis. The categories of dilemma were extracted from a second-round content analysis.ParticipantsParticipants were board-certified paediatricians with sufficient experience in making decisions in relation to children with severe illnesses or disabilities. We repeated purposive sampling and analyses until we reached saturation of the category data.ResultsWe performed interviews with 15 paediatricians. They each reported both unique and overlapping categories of dilemmas that they encountered when making critical decisions. The dilemmas included five types of causal elements: (1) paediatricians’ convictions; (2) the quest for the best interests of patients; (3) the quest for medically appropriate plans; (4) confronting parents and families and (5) socioenvironmental issues. Dilemmas occurred and developed as conflicting interactions among these five elements. We further categorised these five elements into three principal domains: the decision-maker (decider); consensus making among families, colleagues and society (process) and the consequential output of the decision (consequence).ConclusionsThis is the first qualitative study to demonstrate the framework of paediatricians’ decision-making processes and the complex structures of dilemmas they face. Our data indicate the necessity of establishing and implementing an effective support system for paediatricians, such as structured professional education and arguments for creating social consensus that assist them to reach the best plan for the management of severely ill children.

scholarly journals GPs’ decisions about prescribing anticipatory medicines at the end of life: a qualitative study

2019 ◽  
Vol 69 (suppl 1) ◽  
pp. bjgp19X702809
Author(s):  
Ben Bowers ◽  
Kristian Pollock ◽  
Sam Barclay ◽  
Stephen Barclay
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
End Of Life ◽  
Thematic Analysis ◽  
Symptom Management ◽  
Symptom Relief ◽  
Structured Interviews ◽  
Family Experiences ◽  
Decision Making Processes ◽  
Purposive Sample

BackgroundGPs have a central role in decisions about prescribing anticipatory medications (AMs) to help control symptoms at the end of life. Little is known about GPs’ decision-making processes in prescribing AMs and the subsequent use of prescribed drugs.AimTo explore GPs’ decision-making processes in the prescribing and use of AMs for patients at the end of life.MethodA qualitative interpretive descriptive enquiry with a purposive sample of 13 GPs working across one English county. Data was collected in 2017 via semi-structured interviews and analysed inductively using Braun and Clarke’s thematic analysis.ResultsThree themes were constructed from the data: 1) ‘Something we can do’: AMs were a tangible intervention GPs felt they could offer to provide symptom relief for patients approaching death. 2) ‘Getting the timing right’: the prescribing of AMs was recognised as a harbinger of death for patients and families. GPs preferred to prescribe drugs weeks before death was expected, while recognising this meant that many prescribed AMs were never used. 3) ‘Delegating care while retaining accountability’: GPs relied on nurse to assess when to administer drugs and keep them updated about their use.ConclusionGPs view AMs as key to symptom management for dying people. AMs are routinely prescribed even though they are often not used. In order to feel comfortable delegating care, GPs need regular access to nurses and trust in their skills to administer drugs appropriately. Patient and family experiences of AMs, and their preference for involvement in decision-making about their use warrant urgent investigation.

scholarly journals Exploring Consumer Decision-making Processes Regarding the Adoption of Mobile Payments: A Qualitative Study

2017 ◽  
Vol 2 (3) ◽  
pp. 108-115
Author(s):  
Raden Agoeng Bhimasta ◽  
Budi Suprapto
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Jel Classification ◽  
Mobile Payment ◽  
Consumer Decision Making ◽  
Consumer Decision ◽  
Mobile Payments ◽  
Decision Making Processes ◽  
Innovation Diffusion Process ◽  
Financial Technology

Objective - The main objective of this study is to gain deeper understanding on the decision-making process of how and why consumers are adopting mobile payment in Indonesia. Methodology/Technique - The study was a qualitative study that included an experiment to the research design. A total of six young people were voluntarily participated in the study. Our finding provides explanation of salient factors that might drive or hinder the adoption in five different stages of innovation-diffusion process. Findings – Overall, our finding indicated that the attractiveness of rewards was an intriguing factor that greatly influences consumer decision whether to use mobile payment or not. Novelty - The uniqueness of our study lies on the use of innovative approaches to address the mobile payment adoption issues from different perspective than prior literatures. Type of Paper - Empirical Keywords: Consumers' Decision-Making; Financial Technology; Innovation-Decision Process; Mobile Payment Adoption; Technology Adoption. JEL Classification: M15, M31.

scholarly journals The compound role of a coordinator for home-dwelling persons with dementia and their informal caregivers: A qualitative study

2020 ◽  
Author(s):  
Stein Erik Fæø ◽  
Oscar Tranvåg ◽  
Rune Samdal ◽  
Bettina S. Husebo ◽  
Frøydis Bruvik
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Clinical Pathways ◽  
Informal Caregivers ◽  
Safety Net ◽  
Fundamental Rights ◽  
Care And Support ◽  
Starting Point ◽  
Decision Making Processes ◽  
Person With Dementia

Abstract Background: As the number of persons with dementia is increasing, there has been a call for establishing sustainable clinical pathways for coordinating care and support for this group. The [email protected] trial is a multicomponent, multi-disciplinary intervention combining learning, innovation, volunteer support and empowerment. To implement the intervention, a municipal coordinator has a crucial role. Implementation research on multicomponent interventions is complex and we conducted a qualitative study, aiming to explore the coordinator role and how a coordinator may empower persons with dementia in decision-making processes. Methods: Qualitative program evaluation combined with a hermeneutic interpretive approach was chosen as methodological approach. Sixteen dyads, consisting of the person with dementia and their main informal caregiver received the intervention by two coordinators. Of these, six dyads, three informal caregivers alone and the two care coordinators along with their leader, in sum, eighteen persons, participated in in-depth or focus group interviews, sharing their experiences after six months intervention.Results: We found that the coordinators fulfilled three functions for the participating dyads: being a safety net, meaning that the dyads might have little needs at the moment, but found safety in a relation to someone who might help if the situation should change; being a pathfinder, meaning that they supported the dyads in finding their way through the complicated system of care and support services; being a source for emotional care and support, meaning that they listened, acknowledged and gave counsel in times of distress. The coordinators emphasized that a trusting leader and work environment was crucial for them to fulfill these functions. We also found that it was challenging for the coordinators to build a relation to the persons with dementia in order to pursue genuine empowerment in decision-making processes. Conclusion: We found the framework for follow-up to be a feasible starting point for establishing empowering coordination and a sustainable care pathway for persons with dementia and their informal caregivers. More meeting points between coordinator and person with dementia should be pursued in order to fulfill the persons’ fundamental rights to participate in decision-making processes.

scholarly journals Understanding the low take-up of home-based dialysis through a shared decision-making lens: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e053937
Author(s):  
Jane Noyes ◽  
Gareth Roberts ◽  
Gail Williams ◽  
James Chess ◽  
Leah Mc Laughlin
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Shared Decision Making ◽  
Healthcare Professionals ◽  
Family Members ◽  
Shared Decision ◽  
Framework Analysis ◽  
Future Treatment ◽  
Modifiable Factors ◽  
Decision Making Processes

ObjectivesTo explore how people with chronic kidney disease who are pre-dialysis, family members and healthcare professionals together navigate common shared decision-making processes and to assess how this impacts future treatment choice.DesignCoproductive qualitative study, underpinned by the Making Good Decisions in Collaboration shared decision-model. Semistructured interviews with a purposive sample from February 2019 - January 2020. Interview data were analysed using framework analysis. Coproduction of logic models/roadmaps and recommendations.SettingFive Welsh kidney services.Participants95 participants (37 patients, 19 family members and 39 professionals); 44 people supported coproduction (18 patients, 8 family members and 18 professionals).FindingsShared decision-making was too generic and clinically focused and had little impact on people getting onto home dialysis. Preferences of where, when and how to implement shared decision-making varied widely. Apathy experienced by patients, caused by lack of symptoms, denial, social circumstances and health systems issues made future treatment discussions difficult. Families had unmet and unrecognised needs, which significantly influenced patient decisions. Protocols containing treatment hierarchies and standards were understood by professionals but not translated for patients and families. Variation in dialysis treatment was discussed to match individual lifestyles. Patients and professionals were, however, defaulting to the perceived simplest option. It was easy for patients to opt for hospital-based treatments by listing important but easily modifiable factors.ConclusionsShared decision-making processes need to be individually tailored with more attention on patients who could choose a home therapy but select a different option. There are critical points in the decision-making process where changes could benefit patients. Patients need to be better educated and their preconceived ideas and misconceptions gently challenged. Healthcare professionals need to update their knowledge in order to provide the best advice and guidance. There needs to be more awareness of the costs and benefits of the various treatment options when making decisions.

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