The potential impact of decision role and patient age on end-of-life treatment decision making

2008 ◽  
Vol 34 (5) ◽  
pp. 327-331 ◽  
Author(s):  
B J Zikmund-Fisher ◽  
H P Lacey ◽  
A Fagerlin
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Treatment Decision ◽  
Patient Age ◽  
Treatment Decision Making ◽  
Patient Âgé ◽  
Potential Impact ◽  
End Of Life Treatment

scholarly journals How do specialist surgeons treat the atrophic tooth gap? A vignette-based study among maxillofacial and oral surgeons

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Michael Korsch ◽  
Winfried Walther ◽  
Bernt-Peter Robra ◽  
Aynur Sahin ◽  
Matthias Hannig ◽  
...  
Keyword(s):  
Decision Making ◽  
Treatment Decision ◽  
Bisphosphonate Therapy ◽  
Bone Block ◽  
Patient Anxiety ◽  
Patient Age ◽  
Endocarditis Prophylaxis ◽  
Therapy Decision ◽  
Patient Âgé ◽  
Case Vignettes

Abstract Background There is little information available regarding the decision-making process of clinicians, especially in the choice of therapy for a severely atrophic tooth gap. The aim of this research was to use case vignettes to determine the influence of possible factors on the decision making of maxillofacial and oral surgeons. Methods A total of 250 maxillofacial (MFS) and oral (OS) surgeons in southern Germany were surveyed for atrophic single- or multiple-tooth gap with the help of case vignettes. The influence of different determinants on the therapy decision was investigated. Two case vignettes were designed for this purpose: vignette 1 with determinants “patient age” and “endocarditis prophylaxis” and vignette 2 with determinants “anxiety” and “bisphosphonate therapy”. Furthermore, the specialist designation was assessed for both. The options available to achieve a sufficient implant site were "bone split", "bone block", "augmentation with bone substitute material" and "bone resection". Therapy was either recommended or rejected based on principle. Results A total of 117 participants returned the questionnaire: 68 (58%) were OS and 49 (42%) MFS. “Patient age” and “patient anxiety” were not significantly associated with any therapy decision. However, required “endocarditis prophylaxis” led to significantly higher refusal rates for "bone split", "bone block" and "bone replacement material" and to higher rates of general refusal of a therapy. “Bisphosphonate therapy” was significantly associated with general refusal of therapy, but with no significant correlation with different therapy options. In vignette 1, OS refused therapy significantly more often than MFS, though there was no association with the specialist designation for other therapy modalities. In vignette 2, specialty was not significantly associated with the therapy decision. Conclusion “Patient age” as well as “patient anxiety” appear to have no or little influence on the treatment decision for severely atrophic single- or multiple-tooth gap by specialist surgeons. Surgeons more often refuse treatment for patients with endocarditis prophylaxis and bisphosphonate therapy.

scholarly journals How Do Specialist Surgeons Treat the Atrophic Tooth Gap? - A Vignette-based Study Among Maxillofacial and Oral Surgeons

2020 ◽  
Author(s):  
Michael Korsch ◽  
Winfried Walther ◽  
Bernt-Peter Robra ◽  
Aynur Sahin ◽  
Matthias Hannig ◽  
...  
Keyword(s):  
Decision Making ◽  
Treatment Decision ◽  
Bisphosphonate Therapy ◽  
Bone Block ◽  
Patient Anxiety ◽  
Patient Age ◽  
Endocarditis Prophylaxis ◽  
Therapy Decision ◽  
Patient Âgé ◽  
Case Vignettes

Abstract BackgroundThere is little information available regarding the decision-making process of clinicians, especially in the choice of therapy for a severely atrophic tooth gap. The aim of this research was to use case vignettes to determine the influence of possible factors on the decision making of maxillofacial and oral surgeons.MethodsA total of 250 maxillofacial (MFS) and oral (OS) surgeons in southern Germany were surveyed for atrophic single- or multiple-tooth gap with the help of case vignettes. The influence of different determinants on the therapy decision was investigated. Two case vignettes were designed for this purpose: vignette 1 with determinants “patient age” and “endocarditis prophylaxis” and vignette 2 with determinants “anxiety” and “bisphosphonate therapy”. Furthermore, the specialist designation was assessed for both. The options available to achieve a sufficient implant site were "bone split", "bone block", "augmentation with bone substitute material" and "bone resection". Therapy was either recommended or rejected based on principle.ResultsA total of 117 participants returned the questionnaire: 68 (58%) were OS and 49 (42%) MFS. “Patient age” and “patient anxiety” were not significantly associated with any therapy decision. However, required “endocarditis prophylaxis” led to significantly higher refusal rates for "bone split", "bone block" and "bone replacement material" and to higher rates of general refusal of a therapy. “Bisphosphonate therapy” was significantly associated with general refusal of therapy, but with no significant correlation with different therapy options. In vignette 1, OS refused therapy significantly more often than MFS, though there was no association with the specialist designation for other therapy modalities. In vignette 2, specialty was not significantly associated with the therapy decision.Conclusion“Patient age” as well as “patient anxiety” appear to have no or little influence on the treatment decision for severely atrophic single- or multiple-tooth gap by specialist surgeons. Surgeons more often refuse treatment for patients with endocarditis prophylaxis and bisphosphonate therapy.

scholarly journals Patients' Preferences for Participation in Treatment Decision-Making at the End of Life: Qualitative Interviews with Advanced Cancer Patients

PLoS ONE ◽  
2014 ◽  
Vol 9 (6) ◽  
pp. e100435 ◽  
Author(s):  
Linda Brom ◽  
H. Roeline W. Pasman ◽  
Guy A. M. Widdershoven ◽  
Maurice J. D. L. van der Vorst ◽  
Jaap C. Reijneveld ◽  
...  
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Qualitative Interviews ◽  
Treatment Decision ◽  
Advanced Cancer Patients ◽  
Treatment Decision Making

The Influence of Patient and Provider Religious and Spiritual Beliefs on Treatment Decision Making in the Cancer Care Context

2021 ◽  
pp. 0272989X2110222
Author(s):  
Elizabeth Palmer Kelly ◽  
Brian Myers ◽  
Brent Henderson ◽  
Petra Sprik ◽  
Kelsey B. White ◽  
...  
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Advance Care Planning ◽  
Cancer Care ◽  
Treatment Decision ◽  
Care Planning ◽  
Care Providers ◽  
Treatment Decision Making ◽  
Advance Care ◽  
The Impact

Background Providers often underestimate the influence of patient religious and spiritual (R&S) needs. The current study sought to determine the influence of R&S beliefs on treatment decision making among patients and providers in the context of cancer care. Methods We conducted a systematic review of the literature using web-based search engines and discipline-specific databases. Search terms included a combination of the following Medical Subject Headings and key terms: “cancer,”“spirituality,”“religion,” and “decision making.” We used Covidence to screen relevant studies and extracted data into Microsoft Excel. Results Among 311 screened studies, 32 met inclusion/exclusion criteria. Most studies evaluated the patient perspective ( n = 29), while 2 studies evaluated the provider perspective and 1 study examined both. In assessing patient R&S relative to treatment decision making, we thematically characterized articles according to decision-making contexts, including general ( n = 11), end-of-life/advance care planning ( n = 13), and other: specific ( n = 8). Specific contexts included, but were not limited to, clinical trial participation ( n = 2) and use of complementary and alternative medicine ( n = 4). Within end-of-life/advance care planning, there was a discrepancy regarding how R&S influenced treatment decision making. The influence of R&S on general treatment decision making was both active and passive, with some patients wanting more direct integration of their R&S beliefs in treatment decision making. In contrast, other patients were less aware of indirect R&S influences. Patient perception of the impact of R&S on treatment decision making varied relative to race/ethnicity, being more pronounced among Black patients. Conclusion Most articles focused on R&S relative to treatment decision making at the end of life, even though R&S appeared important across the care continuum. To improve patient-centered cancer care, providers need to be more aware of the impact of R&S on treatment decision making.

Treatment decision‐making at the end of life: a survey of Australian doctors' attitudes towards patients' wishes and euthanasia

1996 ◽  
Vol 165 (10) ◽  
pp. 540-544 ◽  
Author(s):  
Charles Waddell ◽  
Roger M Clarnette ◽  
Michael Smithy ◽  
Lynn Oldham ◽  
Allan Kellehear
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Treatment Decision ◽  
Treatment Decision Making ◽  
Patients Wishes
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