Nurses' Conceptions of Decision Making Concerning Life-Sustaining Treatment

2008 ◽  
Vol 15 (2) ◽  
pp. 160-173 ◽  
Author(s):  
Marit Silén ◽  
Mia Svantesson ◽  
Gerd Ahlström
Keyword(s):  
Decision Making ◽  
Qualitative Content Analysis ◽  
Future Research ◽  
Dialysis Patients ◽  
Next Of Kin ◽  
Test Models ◽  
Semistructured Interviews ◽  
Nurses Role ◽  
Life Sustaining Treatment

The aim of this study was to describe nurses' conceptions of decision making with regard to life-sustaining treatment for dialysis patients. Semistructured interviews were conducted with 13 nurses caring for such patients at three hospitals. The interview material was subjected to qualitative content analysis. The nurses saw decision making as being characterized by uncertainty and by lack of communication and collaboration among all concerned. They described different ways of handling decision making, as well as insufficiency of physician—nurse collaboration, lack of confidence in physicians, hindrances to patient participation, and ambivalence about the role of patients' next of kin. Future research should test models for facilitating communication and decision making so that decisions will emerge from collaboration of all concerned. Nurses' role in decision making also needs to be discussed.

scholarly journals Decision Making from the Experience of Orthognathic Surgery Patients: A Grounded Theory Approach

2021 ◽  
pp. 238008442110144
Author(s):  
N.R. Paul ◽  
S.R. Baker ◽  
B.J. Gibson
Keyword(s):  
Decision Making ◽  
Grounded Theory ◽  
Treatment Options ◽  
Study Data ◽  
Primary Objective ◽  
Major Surgery ◽  
Future Research ◽  
Decision Making Process ◽  
Theory Approach

Introduction: Patients’ decisions to undergo major surgery such as orthognathic treatment are not just about how the decision is made but what influences the decision. Objectives: The primary objective of the study was to identify the key processes involved in patients’ experience of decision making for orthognathic treatment. Methods: This study reports some of the findings of a larger grounded theory study. Data were collected through face-to-face interviews of patients who were seen for orthognathic treatment at a teaching hospital in the United Kingdom. Twenty-two participants were recruited (age range 18–66 y), of whom 12 (male = 2, female = 10) were 6 to 8 wk postsurgery, 6 (male = 2, female = 4) were in the decision-making stage, and 4 (male = 0, female = 4) were 1 to 2 y postsurgery. Additional data were also collected from online blogs and forums on jaw surgery. The data analysis stages of grounded theory methodology were undertaken, including open and selective coding. Results: The study identified the central role of dental care professionals (DCPs) in several underlying processes associated with decision making, including legitimating, mediating, scheduling, projecting, and supporting patients’ decisions. Six categories were related to key aspects of decision making. These were awareness about their underlying dentofacial problems and treatment options available, the information available about the treatment, the temporality of when surgery would be undertaken, the motivations and expectation of patients, social support, and fear of the surgery, hospitalization, and potentially disliking their new face. Conclusion: The decision-making process for orthognathic treatment is complex, multifactorial, and heavily influenced by the role of DCPs in patient care. Understanding the magnitude of this role will enable DCPs to more clearly participate in improving patients’ decision-making process. The findings of this study can inform future quantitative studies. Knowledge Transfer Statement: The results of this study can be used both for informing clinical practice around enabling decision making for orthognathic treatment and also for designing future research. The findings can better inform clinicians about the importance of their role in the patients’ decision-making process for orthognathic treatment and the means to improve the patient experience. It is suggested that further research could be conducted to measure some of the key constructs identified within our grounded theory and assess how these change during the treatment process.

scholarly journals Exploring Factors Affecting the Emergency Specialists’ Decision-Making in Case of Emergencies in Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Abbasali Ebrahimian ◽  
Seyed-Hossein Hashemi-Amrei ◽  
Mohammadreza Monesan
Keyword(s):  
Decision Making ◽  
Emergency Department ◽  
Qualitative Content Analysis ◽  
Decision Makers ◽  
Decision Making Process ◽  
Factors Affecting ◽  
Emergency Situations ◽  
The Core ◽  
Semistructured Interviews ◽  
Emergency Decision

Introduction. Appropriate decision-making is essential in emergency situations; however, little information is available on how emergency decision-makers decide on the emergency status of the patients shifted to the emergency department of the hospital. This study aimed at explaining the factors that influence the emergency specialists’ decision-making in case of emergency conditions in patients. Methods. This study was carried out with a qualitative content analysis approach. The participants were selected based on purposive sampling by the emergency specialists. The data were collected through semistructured interviews and were analyzed using the method proposed by Graneheim and Lundman. Results. The core theme of the study was “efforts to perceive the acute health threats of the patient.” This theme was derived from the main classes, including “the identification of the acute threats based on the patient’s condition” and “the identification of the acute threats based on peripheral conditions.” Conclusions. The conditions governing the decision-making process about patients in the emergency department differ from the conditions in other health-care departments at hospitals. Emergency specialists may have several approaches to decide about the patients’ emergency conditions. Therefore, notably, the emergency specialists’ working conditions and the others’ expectations from these specialists should be considered.

scholarly journals AI-Enabled Sensing and Decision-Making for IoT Systems

Complexity ◽  
2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Hao Qinxia ◽  
Shah Nazir ◽  
Ma Li ◽  
Habib Ullah ◽  
Wang Lianlian ◽  
...  
Keyword(s):  
Decision Making ◽  
Real Life ◽  
Research Community ◽  
Smart Sensors ◽  
Future Research ◽  
New Paradigm ◽  
Exclusion Criteria ◽  
Intelligent Devices ◽  
Research Questions

The influential stage of Internet of Things (IoT) has reformed all fields of life in general but specifically with the emergence of artificial intelligence (AI) has drawn the attention of researchers into a new paradigm of life standard. This revolution has been accepted around the globe for making life easier with the use of intelligent devices such as smart sensors, actuators, and many other devices. AI-enabled devices are more intelligent and capable of doing a specific task which saves a lot of resources and time. Different approaches are available in the existing literature to tackle diverse issues of real life based on AI and IoT systems. The role of decision-making has its own importance in the AI-enabled and IoT systems. In-depth knowledge of the existing literature is dire need of the research community to summarize the literature in effective way by which practitioners and researchers can benefit from the prevailing proofs and suggest new solutions for solving a particular problem of AI-enabled sensing and decision-making for the IoT system. To facilitate research community, the proposed study presents a systematic literature review of the existing literature, organizes the evidences in a systematic way, and then analyzes it for future research. The study reported the literature of the last 5 years based on the research questions, inclusion and exclusion criteria, and quality assessment of the selected study. Finally, derivations are drawn from the included paper for future research.

The Role of GIS in City Competitiveness

2013 ◽  
pp. 1476-1501 ◽  
Author(s):  
Khan R. Rahaman ◽  
Júlia M. Lourenço
Keyword(s):  
Decision Making ◽  
Information System ◽  
Spatial Data ◽  
Information Access ◽  
Information Storage ◽  
Future Research ◽  
Gis Technology ◽  
Global Competitiveness ◽  
The World

Virtually every city and region is engaged in activities to improve their relative global competitiveness. The Geographic Information System (GIS) is one of the powerful tools of information storage and information access, providing spatial data to different stakeholders and cities across the world. This chapter will highlight the role of GIS technology in empirical assessment of the competition among cities or regions, using a variety of data assembled by many different individuals, businesses, and institutions. This valuable information can be used in decision-making by stakeholders who are taking part in the competition and can be disseminated, accessed, and updated in a dynamic way. This chapter discusses the origins of urban competitiveness, dynamics and functions of competition, and current and future research possibilities made possible by GIS.

The role of mobile devices in 21st-century family communication

2018 ◽  
Vol 7 (2) ◽  
pp. 248-264 ◽  
Author(s):  
Sharon L. Storch ◽  
Anna V. Ortiz Juarez-Paz
Keyword(s):  
Decision Making ◽  
Mobile Devices ◽  
Family Communication ◽  
Extended Family ◽  
Emotional Responses ◽  
Future Research ◽  
Structured Interviews ◽  
Theory Analysis ◽  
The Past

Use of media devices has evolved over the past 10–15 years and the resulting effects on family communication are of interest for this study. Through 26 semi-structured interviews, the authors sought to understand the role mobile devices play in family communication. Qualitative grounded theory analysis was used to find themes and interpret results (Creswell, 2013). One overarching paradoxical theme emerged from these data, family connect–family disconnect. In family connect, categories of across distance, reassurances, and boundaries are shared. Within family disconnect, distractions, misunderstandings, and negative emotional responses are conveyed. Future research avenues recommended are decision making related to mobile devices based on values and morals, in-depth social media and app usage, emoji emotional responses, individuals under 18 and between 18 and 30 years old, and a network analysis of one extended family.

The role of compliance for organisational change

2018 ◽  
Vol 31 (2) ◽  
pp. 334-351 ◽  
Author(s):  
Ronald Busse ◽  
Ufuk Doganer
Keyword(s):  
Qualitative Methodology ◽  
Qualitative Content Analysis ◽  
Organisational Change ◽  
Future Research ◽  
Content Type ◽  
Lively Debate ◽  
And Performance ◽  
The Individual ◽  
Depth Interviews

Purpose Fuelled by the latest scandals at Siemens, VW or Walmart, there is a lively debate on the role of compliance and ethics programmes. Unlike large corporations, small and medium-sized enterprises (SMEs) arguably tend to underestimate their significance and lag behind. Hence, the purpose of this paper is to shed light on the process of introducing compliance codes and its effects on employee acceptance and performance. Design/methodology/approach In line with the qualitative methodology, the authors conducted 12 in-depth interviews with German SME employees which the authors evaluated with the qualitative content analysis. Findings As for the major contribution, results indicate the emergence of a lack of understanding, anger, anxiety and operational performance losses – both at the individual and the corporate level – especially when employees feel uninvolved in the initial introduction stadium. Originality/value Practicing managers may benefit from the recommendation to facilitate staff involvement at earlier stages. As for theory advancement, the authors draw on Kotter’s (2007) long surviving “Eight Steps Change Management Model” and find significant support for shifting the spotlight of attention towards the first four phases. The authors discuss the original value of the research, admit limitations and illuminate some promising future research trajectories.

Should euthanasia and assisted suicide for psychiatric disorders be permitted? A systematic review of reasons

2020 ◽  
Vol 50 (8) ◽  
pp. 1241-1256
Author(s):  
Marie E. Nicolini ◽  
Scott Y. H. Kim ◽  
Madison E. Churchill ◽  
Chris Gastmans
Keyword(s):  
Systematic Review ◽  
Policy Making ◽  
Assisted Suicide ◽  
Qualitative Content Analysis ◽  
Self Determination ◽  
Future Research ◽  
Decisional Capacity ◽  
Goals Of Medicine ◽  
Ethical Debate ◽  
Life Sustaining Treatment

AbstractBackgroundEuthanasia and assisted suicide (EAS) based on a psychiatric disorder (psychiatric EAS) continue to pose ethical and policy challenges, even in countries where the practice has been allowed for years. We conducted a systematic review of reasons, a specific type of review for bioethical questions designed to inform rational policy-making. Our aims were twofold: (1) to systematically identify all published reasons for and against the practice (2) to identify current gaps in the debate and areas for future research.MethodsFollowing the PRISMA guidelines, we performed a search across seven electronic databases to include publications focusing on psychiatric EAS and providing ethical reasons. Reasons were grouped into domains by qualitative content analysis.ResultsWe included 42 articles, most of which were written after 2013. Articles in favor and against were evenly distributed. Articles in favor were mostly full-length pieces written by non-clinicians, with articles against mostly reactive, commentary-type pieces written by clinicians. Reasons were categorized into eight domains: (1) mental and physical illness and suffering (2) decisional capacity (3) irremediability (4) goals of medicine and psychiatry (5) consequences for mental health care (6) psychiatric EAS and suicide (7) self-determination and authenticity (8) psychiatric EAS and refusal of life-sustaining treatment. Parity- (or discrimination-) based reasons were dominant across domains, mostly argued for by non-clinicians, while policy reasons were mostly pointed to by clinicians.ConclusionsThe ethical debate about psychiatric EAS is relatively young, with prominent reasons of parity. More direct engagement is needed to address ethical and policy considerations.

How does familiarity shape destination image and loyalty for visitors and residents?

2020 ◽  
pp. 135676672096974
Author(s):  
Gian Luca Casali ◽  
Yulin Liu ◽  
Angelo Presenza ◽  
Char-Lee Moyle
Keyword(s):  
Decision Making ◽  
Destination Image ◽  
Future Research ◽  
Tourism Destination ◽  
Holistic Model ◽  
Behavioural Intentions ◽  
Place Image ◽  
Decision Making Processes

Destination familiarity is thought to critically influence tourists’ decision-making processes. Yet the role of familiarity in shaping tourists’ and residents’ image of, and loyalty to, a destination remains uncertain. This research tests a complex and holistic model of familiarity, affective, cognitive and overall images, and the conative behavioural intentions of visiting and recommending the destination for both residents and visitors in the context of the emerging tourism destination of Molise, Italy. The results reveal that residents and visitors differ in terms of their familiarity and intention to visit a place, with familiarity being less likely to influence residents’ intentions. There is heterogeneity between residents and visitors’ affective image and intention to visit, as well as between their overall image and intention to recommend Molise. Hence, unlike visitors, residents are more likely to respond to factual cognitive imaging, rather than emotional messaging, suggesting that shifting residents’ perceptions of place image requires a different approach to that of visitors. Future research should seek to confirm the relationships in a multi-destination study.

Cabinet Decision-making in Parliamentary Systems

2020 ◽  
pp. 437-459
Author(s):  
Michelangelo Vercesi
Keyword(s):  
Decision Making ◽  
Power Distribution ◽  
Future Research ◽  
Decision Making Process ◽  
Prime Ministers ◽  
Main Research ◽  
Collective Decisions ◽  
Parliamentary Systems ◽  
Research Questions

This chapter deals with the internal decision-making process of political executives in parliamentary systems, that is, how executives take their own collective decisions. The focus is on the cabinet system as a whole, including both cabinet members and other involved party-political and bureaucratic actors. In particular, the chapter reviews literature’s debates about the nature of cabinet government, the role of prime ministers, and variations of decision-making. A special attention is payed to factors explaining intra-cabinet power distribution and the choice of different decision-making arenas. After introducing the topic, an overview of conceptual issues and main research questions is provided. Subsequently, the work discusses the way in which scholars have addressed these issues and the findings they have reached. The final part stresses existing deficits and seeks to set the agenda for future research.

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