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.

End-of-Life Nutrition Considerations: Attitudes, Beliefs, and Outcomes

2020 ◽  
pp. 104990912096012
Author(s):  
Tyler S. Loofs ◽  
Kevin Haubrick
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Health Outcomes ◽  
End Of Life ◽  
Meta Analysis ◽  
Artificial Nutrition ◽  
Decision Making Process ◽  
Artificial Nutrition And Hydration ◽  
Palliative Care Teams ◽  
Nutrition And Hydration

Objective: To assess the physiological outcomes and interpersonal influences that should be considered when making the decision to provide artificial nutrition and hydration (AN&H) for patients in hospice/palliative programs. Methods: A systematic review was conducted using items from the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 checklist. Distinct search strategies were employed to find primary research articles that addressed: General health outcomes of artificial nutrition and hydration interventions and nutrition therapy interventions (n = 16), nutrition-related symptoms in end-of-life care (n = 8), and the attitudes of patients and providers toward artificial nutrition and hydration (n = 21). Results: The effect of AN&H on health outcomes, quality-of-life measures and nutrition-related symptoms is limited and may vary by patient setting and diagnosis. In the absence of consistent evidence for specific health outcomes, decisions regarding AN&H should be made in context of the desires and beliefs of a patient, their family, and their medical providers. These beliefs may not be consistent with likely outcomes or may be inconsistent between individuals involved in the decision-making process, and individuals of different cultures or geographic regions may approach AN&H decisions from different perspectives. To help navigate the intersection of nutrition-related health outcomes and patient/provider beliefs, palliative care teams may employ a variety of strategies for approaching the decision-making process, and may benefit from specific involvement of a Registered Dietitian to help contribute to or lead these discussions.

scholarly journals Communication in decision aids for stage I–III colorectal cancer patients: a systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e044472
Author(s):  
Saar Hommes ◽  
Ruben Vromans ◽  
Felix Clouth ◽  
Xander Verbeek ◽  
Ignace de Hingh ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Decision Making ◽  
Systematic Reviews ◽  
Decision Aids ◽  
Specific Treatment ◽  
Cochrane Library ◽  
Plain Language ◽  
Patient Decision

ObjectivesTo assess the communicative quality of colorectal cancer patient decision aids (DAs) about treatment options, the current systematic review was conducted.DesignSystematic review.Data sourcesDAs (published between 2006 and 2019) were identified through academic literature (MEDLINE, Embase, CINAHL, Cochrane Library and PsycINFO) and online sources.Eligibility criteriaDAs were only included if they supported the decision-making process of patients with colon, rectal or colorectal cancer in stages I–III.Data extraction and synthesisAfter the search strategy was adapted from similar systematic reviews and checked by a colorectal cancer surgeon, two independent reviewers screened and selected the articles. After initial screening, disagreements were resolved with a third reviewer. The review was conducted in concordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DAs were assessed using the International Patient Decision Aid Standards (IPDAS) and Communicative Aspects (CA) checklist.ResultsIn total, 18 DAs were selected. Both the IPDAS and CA checklist revealed that there was a lot of variation in the (communicative) quality of DAs. The findings highlight that (1) personalisation of treatment information in DAs is lacking, (2) outcome probability information is mostly communicated verbally and (3) information in DAs is generally biased towards a specific treatment. Additionally, (4) DAs about colorectal cancer are lengthy and (5) many DAs are not written in plain language.ConclusionsBoth instruments (IPDAS and CA) revealed great variation in the (communicative) quality of colorectal cancer DAs. Developers of patient DAs should focus on personalisation techniques and could use both the IPDAS and CA checklist in the developmental process to ensure personalised health communication and facilitate shared decision making in clinical practice.

scholarly journals Protocol for systematic review: patient decision aids for total hip and knee arthroplasty decision-making

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Lissa Pacheco-Brousseau ◽  
Marylène Charette ◽  
Dawn Stacey ◽  
Stéphane Poitras
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Knee Arthroplasty ◽  
Patient Involvement ◽  
Decision Aids ◽  
Risk Of Bias ◽  
Decision Making Process ◽  
Patient Decision Aids ◽  
Patient Decision ◽  
Hip And Knee Arthroplasty

Abstract Background Total hip and knee arthroplasty are a highly performed surgery; however, patient satisfaction with surgery results and patient involvement in the decision-making process remains low. Patient decision aids (PtDAs) are tools used in clinical practices to facilitate active patient involvement in healthcare decision-making. Nonetheless, PtDA effects have not been systematically evaluated for hip and knee total joint arthroplasty (TJA) decision-making. The aim of this systematic review is to determine the effect of patient decision aids compared to alternative of care on quality and process of decision-making when provided to adults with hip and knee osteoarthritis considering primary elective TJA. Methods This systematic review will follow the Cochrane Handbook for Systematic Reviews. This protocol was reported based on the PRISMA-P checklist guidelines. Studies will be searched in CINAHL, MEDLINE, Embase, PsycINFO, and Web of Science. Eligible studies will be randomized control trial (RCT) evaluating the effect of PtDA on TJA decision-making. Descriptive and meta-analysis of outcomes will include decision quality (knowledge and values-based choice), decisional conflict, patient involvement, decision-making process satisfaction, actual decision made, health outcomes, and harm(s). Risk of bias will be evaluated with Cochrane’s risk of bias tool for RCTs. Quality and strength of recommendations will be appraised with Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Discussion This review will provide a summary of RCT findings on PtDA effect on decision-making quality and process of adults with knee and hip osteoarthritis considering primary elective TJA. Further, it will provide evidence comparing different types of PtDA used for TJA decision-making. This review is expected to inform further research on joint replacement decision-making quality and processes and on ways PtDAs facilitate shared decision-making for orthopedic surgery. Systematic review registration PROSPERO CRD42020171334

A Decision Methodology for Determining Suitable Post-Disaster Accommodations: Reconsidering Effective Indicators for Decision-making Processes

2020 ◽  
Vol 17 (3) ◽  
Author(s):  
S. M. Amin Hosseini ◽  
Albert de la Fuente ◽  
Oriol Pons ◽  
Carmen Mendoza Arroyo
Keyword(s):  
Decision Making ◽  
Case Studies ◽  
Natural Hazard ◽  
Recovery Process ◽  
Decision Making Process ◽  
Temporary Housing ◽  
Universal Approach ◽  
Decision Making Processes ◽  
Main Factors ◽  
Post Disaster

AbstractOne of the main challenges in assisting displaced persons who have lost their homes as a result of a natural hazard is the provision of adequate post-disaster accommodations, such as temporary housing. Although the need for temporary housing has increased around the world in recent years, it has been criticized on economic, environmental, and social grounds. A universal approach to post-disaster accommodations cannot successfully deal with this issue because each recovery process involves a unique set of conditions. Therefore, rather than defining a specific strategy, this study aims to present an approach capable of producing customized strategies based on contextual and social conditions. To this end, first, the main factors influencing the choice of post-disaster accommodations are identified through five case studies. It is concluded that all of the factors can be organized into three main vertices to simplify the highly complex issues involved in post-disaster accommodations. The case studies also show that the decision-making process consists of two main parts. To date, a recurring failure to distinguish between these two parts has led to unsuitable outcomes. Thus, this paper presents a new decision-making methodology, consisting of multiple steps, phases, and indicators based on the main vertices.

Method for Selecting Storage Enterprises Based on IFHA

2015 ◽  
Vol 713-715 ◽  
pp. 1769-1772
Author(s):  
Jie Wu ◽  
Lei Na Zheng ◽  
Tie Jun Pan
Keyword(s):  
Decision Making ◽  
Group Decision Making ◽  
Group Decision ◽  
Decision Makers ◽  
Decision Problems ◽  
Decision Making Process ◽  
Final Decision ◽  
Multiple Decision Makers ◽  
Intuitionistic Fuzzy ◽  
Averaging Operator

In order to reflect the decision-making more scientific and democratic, modern decision problems often require the participation of multiple decision makers. In group decision making process,require the use of intuitionistic fuzzy hybrid averaging operator (IFHA) to get the final decision result.

scholarly journals Active cutaneous warming systems to prevent intraoperative hypothermia: a systematic review

2012 ◽  
Vol 20 (1) ◽  
pp. 183-191 ◽  
Author(s):  
Vanessa de Brito Poveda ◽  
Edson Zangiacomi Martinez ◽  
Cristina Maria Galvão
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Body Temperature ◽  
Cost Benefit ◽  
Controlled Trials ◽  
Decision Making Process ◽  
Circulating Water ◽  
Randomized Controlled ◽  
Intraoperative Hypothermia ◽  
The Cost

This study analyzed the evidence available in the literature concerning the effectiveness of different active cutaneous warming systems to prevent intraoperative hypothermia. This is a systematic review with primary studies found in the following databases: CINAHL, EMBASE, Cochrane Register of Controlled Trials and Medline. The sample comprised 23 randomized controlled trials. There is evidence in the literature indicating that the circulating water garment system is the most effective in maintaining patient body temperature. These results can support nurses in the decision-making process concerning the implementation of effective measures to maintain normothermia, though the decision of health services concerning which system to choose should also take into account its cost-benefit status given the cost related to the acquisition of such systems.

THE EVALUATION OF AN ORE DEPOSIT DEVELOPMENT PROSPECT THROUGH APPLICATION OF THE "GAMES AGAINST NATURE" APPROACH

2013 ◽  
Vol 30 (06) ◽  
pp. 1350029 ◽  
Author(s):  
MARIUSZ KRZAK
Keyword(s):  
Decision Making ◽  
Mineral Deposit ◽  
Ore Deposits ◽  
Supplementary Information ◽  
Decision Making Process ◽  
Final Decision ◽  
Investment Risk ◽  
Economic Market ◽  
Ore Deposit ◽  
Mining Projects

Geological-mining projects are usually associated with relatively high risk and uncertainty in many aspects, including geological, mining, ecologic, economic, market, legal and social conditions. A mineral deposit is an underground natural resource and hence it is difficult to unequivocally predict the actual results of its discovery. Depending on the extent of the resource, the operation of the mine can extend to a few decades. It is necessary to conduct investment actions in successive stages and to evaluate the results of the work stage by stage. This reduces the investment risk and facilitates the decision-making process. In this paper, the use of a specific kind of game, the so-called "game against Nature," is suggested before a final decision on deposit development is made. This methodology was tested on the example of one of the zinc-lead ore deposits in the Silesia-Cracow region. Apart from supporting the decision-making process, this methodology offers the means to evaluate further research and costs which may be incurred for obtaining supplementary information related to the ore deposit parameters, specifically its reserves.

Searching for a Dream Plan: Two-Level Game Analysis of the Futenma Relocation Issue Under the Hatoyama Cabinet

2014 ◽  
Vol 15 (1) ◽  
pp. 51-67
Author(s):  
TOMOHITO SHINODA
Keyword(s):  
Decision Making ◽  
Prime Minister ◽  
Clear Picture ◽  
Decision Making Process ◽  
Final Decision ◽  
Game Analysis ◽  
The Us ◽  
Marine Air

AbstractEmploying a two-level game framework, this study examines the decision-making process of the Hatoyama government on the replacement of the US Marine air base in Futenma, Okinawa. Before reaching the final decision to revert to the existing plan of relocating it to Nago City, the cabinet members explored different possible alternatives. Prime Minister Hatoyama simultaneously pursued different international and domestic goals. Misperception and miscommunication between Tokyo and Washington were at play. A two-level game framework provides a clear picture of what Hatoyama tried to pursue and why he failed.

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