scholarly journals Asthma Patient Involvement in the Treatment Decision-Making Process

2021 ◽  
Author(s):  
A. Kyle ◽  
K. Kueh ◽  
N.B. Yaacob ◽  
B.Y. Cheng ◽  
M. Tan ◽  
...  
Keyword(s):  
Decision Making ◽  
Patient Involvement ◽  
Treatment Decision ◽  
Asthma Patient ◽  
Decision Making Process ◽  
Treatment Decision Making

scholarly journals The deadly “bulging balloon” within the mediastinum: a case of a giant aortic root aneurysm in a young patient with Marfan syndrome

2020 ◽  
Author(s):  
JIAYU SHEN ◽  
Changping Gan ◽  
R.D.T. Rajaguru ◽  
Dou Yuan ◽  
ZHENGHUA XIAO
Keyword(s):  
Decision Making ◽  
Aortic Valve ◽  
Ct Scan ◽  
Young Patient ◽  
Marfan Syndrome ◽  
Aortic Root ◽  
Treatment Decision ◽  
Decision Making Process ◽  
Aortic Root Aneurysm ◽  
Treatment Decision Making

Abstract Introduction: Marfan syndrome (MFS) is a common heritable connective tissue disease involving multiple organs. Even though the clinical manifestations of MFS can be various, aortic root aneurysm is estimated as one of the most serious complications. We herein describe an individualized treatment decision-making process for a 23-year-old male with MFS, suffering from a giant but stable aortic root aneurysm which is extremely rare at his age. Case: The patient, a 23-year-old male with a family history of MFS, presented to our cardiovascular department because of progressive exertional chest distress, fatigue and occasional precordial pain. Physical examinations revealed six-foot-three inches of height, high myopia, and a diastolic murmur at the aortic valve area. Laboratory examinations for systemic vasculitis and infectious diseases were negative. The transthoracic echocardiography (TTE) and enhanced thoracic computed tomography (CT) scan revealed the existence of a giant aortic root aneurysm (125.1 mm in short-axis), severe aortic valve regurgitation, cardiac dilatation (LV; 99 mm in diastolic diameter) and a poor ejection fraction (EF; 18%). Considering the risk of rupture or dissection of the dilated aortic root, we successfully performed the Bentall procedure based on the intraoperative exploration results. Postoperative thoracic CT scan revealed a normal sized reconstructed aortic root, and the patient was discharged uneventfully 7 days later. Conclusion It is extremely rare to report such a giant aortic root aneurysm in a young patient. In the treatment decision-making process, the patient’s specific situation should be taken into consideration. The composite replacement of the aortic valve and ascending aorta should be performed if the patient is not suitable for valve-sparing operation.

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.

Clinical errors that can occur in the treatment decision-making process in psychotherapy.

Psychotherapy ◽  
2016 ◽  
Vol 53 (3) ◽  
pp. 257-261 ◽  
Author(s):  
Jake Park ◽  
Jonathan Goode ◽  
Kelley A. Tompkins ◽  
Joshua K. Swift
Keyword(s):  
Decision Making ◽  
Treatment Decision ◽  
Decision Making Process ◽  
Treatment Decision Making

scholarly journals HUBUNGAN KARAKTERISTIK PASIEN HUMAN IMMUNODEFICIANCY VIRUS (HIV) DENGAN PENGAMBILAN KEPUTUSAN PENGOBATAN DI PUSKESMAS DUPAK

2019 ◽  
Vol 13 (1) ◽  
pp. 61
Author(s):  
Sindi Paratika
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Primary Health Care ◽  
Treatment Decision ◽  
Hiv Treatment ◽  
Hiv Positive ◽  
Decision Making Process ◽  
Alternative Evaluation ◽  
Treatment Decision Making ◽  
Primary Health

Dupak primary health care is one of health care which have complete HIV and Acquired Immuno Deficiency Syndrom (AIDS) prevention program. The number of HIV-AIDS sufferers increasing every year, but the number of new HIV positive cases taking Anti Retroviral Virus(ARV) treatment at Dupak primary health care are low. The purpose of this research was analyzed the HIV treatment decision making process of patients at Dupak primary health care. The method in this research was descriptive quantitive research through questionnaires. Variables of this study are individual characteristics include age, level of education, knowledges, status of severity with decision making process of treatment. The results of this study indicate that most respondents (50%) have a high knowledge of HIV treatment. Decision-making process of HIV positive patient treatment have 2 stages that most respondents didn’t do. There are stage of the information search (75%) and stage of alternative evaluation (56.25%). The conclusion of this research are most respondents didn’t do information searching and alternative evaluation in decision making process at Dupak primary health care. According suggested from this study are to improve HIV related socialization programs through promotional activities and discussions related to HIV treatment services to improve knowledge and activeness of seeking information through print and electronic media.

Patient involvement in multidisciplinary treatment planning (MTP).

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 145-145
Author(s):  
Irene Prabhu Das ◽  
Heather Rozjabek ◽  
Mary L. Fennell ◽  
Katherine Mallin ◽  
E. Greer Gay ◽  
...  
Keyword(s):  
Decision Making ◽  
Online Survey ◽  
Patient Involvement ◽  
Treatment Plan ◽  
Multidisciplinary Treatment ◽  
Treatment Decision ◽  
Case Presentation ◽  
Patient Navigators ◽  
Treatment Decision Making

145 Background: Patient involvement in treatment decision-making has been well-studied. However, little is known about how patients are involved in the MTP process prior to their consideration of treatment options. Methods: An online survey was administered to 1,261 Commission on Cancer (CoC)-accredited programs to describe current MTP practice. Survey items addressed team structure and process, case presentation, and patient involvement. A total of 797 (63%) facilities responded. Multiple aspects of patient involvement focusing on the initial case presentation and post-meeting follow-up regarding information provision and communication are examined. Initial descriptive analyses are presented. Results: 97% of facilities reported patients are not invited to attend MTP meetings. Reasons for not inviting patients included: patients may find it overwhelming (62%), physicians not able to speak freely (58%), liability (43%) and privacy (42%) concerns. Of the facilities that do invite patients, 1/3 reported that patients often or always attend. Treatment recommendations from MTP meetings are shared with patients at 75% of facilities, 42% share treatment plans, and 28% give a meeting summary to patients. Nine percent of facilities do not give patients any information from the meeting. Prior to treatment, a written treatment plan is developed at 43% of facilities, and among these, 15% give the plan to patients. Regarding communication about MTP meetings, facilities reported pre-meeting discussions with attending physicians (95%) and patient navigators (21%). Post-meeting follow-up by 93% of facilities is usually done by physicians, 26% by patient navigators and 16% by PA/NPs, and 66% follow-up within 1 week. Conclusions: Initial findings suggest that even if facilities do not invite patients to MTP meetings, they engage patients in various ways at pre- and post-MTP meetings, providing information and having discussions. Physicians are integral in communicating with patients throughout the MTP process. Further study on the multiple facets of patient involvement in MTP is needed to better understand its influence on treatment decision-making.

Differences between women’s preferred and actual experience with ‘shared decision-making’: A mixed method study.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 34-34
Author(s):  
Deborah Ejem ◽  
J Nicholas Dionne-Odom ◽  
Danny Willis ◽  
Peter Kaufman ◽  
Laura Urquhart ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Metastatic Breast ◽  
Treatment Decision ◽  
Cancer Center ◽  
Decision Making Process ◽  
Shared Decision ◽  
Treatment Decision Making ◽  
Actual Experience ◽  
Decision Making Processes

34 Background: Women with metastatic breast cancer (MBC) face numerous treatment and ACP decisions along their illness trajectory. We aimed to explore the treatment and ACP decision-making processes and decision support needs of women with MBC. Methods: Convergent, parallel mixed methods study (9/08-7/09). Sample included women with MBC managed by 3 breast oncologists at the Norris Cotton Cancer Center, Lebanon, NH. Participants completed a semi-structured interview and standardized decision-making instruments (decision control preferences) at study enrollment (T1; n = 22) and when they faced a decision point or 3 months later (T2; n = 19), whichever came first. Results: Participants (n = 22) where all white, averaged 62 years and were mostly married (54%), retired (45%), had a ≥ bachelor’s degree (45%), and had incomes > $40,000 (50%). On the control preferences scale, most women reported a preference for a ‘shared decision’ with clinician (T1 = 14 (64%) vs T2 = 9 (47%)) compared to making the decision themselves (T1 = 6 (27%) vs T2 = 6 (32%)), or delegating the decision to their doctor (T1 = 2 (9%) vs T2 = 4 (21%)). In semi-structured interviews about their actual treatment decision-making experience, women described experiencing a passive or delegated rather than a shared decision-making process. Conversely, women described a much more active ACP decision-making process that was often shared with family rather than their oncologists. Conclusions: Women selected a “shared” process using a validated tool; however their descriptions of the treatment decision-making processes were inconsistent with their actual experience, which was a more passive process in which they followed the oncologists’ treatment suggestions.

Prostate cancer care in Canada: Informed decision-making, patterns of care, and treatment trends.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 289-289
Author(s):  
Kim Tran ◽  
Rami Rahal ◽  
Carolyn Sandoval ◽  
Geoff Porter ◽  
Sharon Fung ◽  
...  
Keyword(s):  
Decision Making ◽  
Treatment Decision ◽  
Treatment Patterns ◽  
Informed Decision ◽  
Decision Making Process ◽  
Informed Decision Making ◽  
Treatment Decision Making ◽  
Trends Over Time ◽  
Treatment Trends ◽  
Over Time

289 Background: Because treatment options for localized prostate cancer (PCa) have similar survival outcomes but varying side effects, it is important that patients are meaningfully involved in the decision-making process to ensure the chosen treatment aligns with their needs, wants and preferences. Here, we describe PCa patients’ experience with informed decision-making as well as treatment patterns and trends over time. Methods: Focus groups were conducted with 47 men treated for PCa across Canada to understand their cancer journey experience. Thematic analysis was conducted. A subset of this data on informed decision-making is described. Men (≥ 35 years) diagnosed with localized, low-risk PCa from 2011-2013 were identified using data from six provincial cancer registries. Treatment data were identified by linking hospital/cancer centre data with registry data. Descriptive statistics were generated to describe treatment patterns and trends. Results: Focus group participants expressed a desire to be involved in the treatment decision-making process. While many participants felt completely informed about the treatment choices available to them, others felt they had not been properly engaged in the treatment decision-making process. Some participants felt they had opted for surgery or radiation therapy (RT) without full knowledge of the trade-offs between potential benefits and side effects. Others felt they may have made different decisions about their care had they been more informed. From registry data, in 2013 surgery was the most common primary treatment for men with low-risk PCa ranging from 12.0% in New Brunswick to 41.7% in Nova Scotia. RT was the second most common ranging from 6.4% in New Brunswick to 18.3% in Saskatchewan. Varying majorities of men had no record of surgical or radiation treatment, a proxy for active surveillance. Treatment trends over time suggest an increase in the use of non-active treatment approaches from 60.7% in 2011 to 69.9% in 2013. Conclusions: System performance indicators yield useful information about oncology practice patterns and trends. This information is enhanced when combined with patient level information on how men felt about decision-making around their PCa care.

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