scholarly journals Comparison of shared decision making in patients undergoing hemodialysis and peritoneal dialysis for choosing a dialysis modality

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sepide Ghodsian ◽  
Mansour Ghafourifard ◽  
Akram Ghahramanian
Keyword(s):  
Decision Making ◽  
Peritoneal Dialysis ◽  
Shared Decision Making ◽  
Early Stage ◽  
T Test ◽  
Shared Decision ◽  
Dialysis Modality ◽  
Care Providers ◽  
Significant Difference ◽  
The Mean

Abstract Background Shared decision making (SDM) is recognized as the gold standard for patient-centered care. This study aimed to assess and compare the SDM among patients undergoing hemodialysis and peritoneal dialysis for choosing a dialysis modality. Methods This is a cross-sectional study that was performed on 300 dialysis patients (218 HD and 82 PD) referred to two Dialysis Centers. Data were collected using demographic information and a 9-item Shared Decision Making Questionnaire (SDM-Q-9). The data were analyzed using ANOVA and independent t-test by SPSS software. Results The mean SDM-Q-9 score in all samples (PD and HD) was 21.94 ± 15.08 (in a possible range of 0 to 45). Results of the independent t-test showed that the mean SDM-Q-9 score in PD patients (33.11 ± 10.08) was higher than HD patients (17.14 ± 74.24) (p < 0.001). The results showed a statistically significant difference in mean SDM-Q-9 score based on patients’ age, educational level, and income (p < 0.05). Conclusion Implementing shared decision making and providing information on RRT should be started in the early stage of CKD. The health care providers should involve patients with CKD and their families in dialysis-related decisions and it should be started in the early stage of CKD.

scholarly journals Interprofessioal collaboration among Speech Language Pathologists and Nurses in Acute Care in Pakistan

2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Fariha Ambreen Ch ◽  
Muhammad Naveed Babur ◽  
Sajid Rashid ◽  
Maria Liaqat
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Acute Care ◽  
T Test ◽  
P Value ◽  
Shared Decision ◽  
Speech Language Pathologists ◽  
Cross Sectional ◽  
Significant Difference ◽  
Mean Differences

Objective: To find out inter-professional collaboration among speech-language pathologists and nurses in acute care in Pakistan. Methods: This was a cross sectional study which was conducted in all government and private hospitals of Islamabad and Rawalpindi having facility of ICUs after taking consent from authorities. The duration of study was six months from October 2018 to February 2019. A total number of 350 participants (200 nurses, 150 speech language pathologists) working in ICU of different private and government hospitals of Pakistan were included in the study. Standardized questionnaire of “assessment of inter-professioal collaboration scale” (AITCS) was circulated to nurses and speech language pathologists (SLPS) working in ICU with its subscale’s partnership, coordination, cooperation and shared decision making on a 5-point likert scale. Data was analyzed using SPSS version 21. Measure of mean was obtained by independent sample t-test. P-Value less than 0.05 was considered as significant. Results: Statistical analysis showed measures of mean differences obtained by t-test revealed significant differences at p<0.001 level between partnership scores of SLPS and nurses. This reveals good partnership between two disciplines. Measures of mean differences obtained by t-test revealed significant differences at p<0.001 level between partnership scores of SLPS and nurses. Both do not value each other in cooperation. Measures of mean differences obtained by t-test showed significant differences at p<0.001 level amongst coordination scores of SLPS and nurses. Both have good coordination. Measures of mean differences obtained by t-test revealed significant differences at p<0.001 level amongst shared decision-making scores of SLPS and nurses. Both are involved in shared decision making. Conclusion: Results show significant difference in partnership, coordination, and shared decision making. There is no significant difference in cooperation. doi: https://doi.org/10.12669/pjms.37.2.3545 How to cite this:Ch FA, Babur MN, Rashid S, Liaqat M. Interprofessioal collaboration among Speech Language Pathologists and Nurses in Acute Care in Pakistan. Pak J Med Sci. 2021;37(2):---------. doi: https://doi.org/10.12669/pjms.37.2.3545 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Patients' Decision Making Preferences and Perceived Participation in Care: A Case Study in Selected Educational Hospitals of Yazd

2021 ◽  
Author(s):  
Mohamad Amin Bahrami ◽  
Hasan Jafari ◽  
Sara Jambarsang ◽  
Samane Entezarian Ardakani
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Shared Decision Making ◽  
Health Care Providers ◽  
Decision Making Process ◽  
Shared Decision ◽  
Willingness To Participate ◽  
Care Providers ◽  
The Mean ◽  
The Difference

Background: Patient's preferences in decision-making procedure are defined as the patient's willingness to participate in self-care management and decision-making. The aim of present study was to assess patients' preferences in decision-making procedure and perceived participation in care and their relationship with demographic in selected educational hospitals of Yazd in 2019. Methods: The study was conducted on 195 inpatients of the gynecology, internal medicine and surgery wards of teaching hospitals in Yazd of Iran. The inpatients were selected through stratified sampling method. The data was collected by 2 questionnaires: Degner and Sloan's control preferences scale and patients' perceived involvement in care scale of Lerman et al. parametric and non-parametric tests used to analyze the data. Results: In general, 49.20 % of patients preferred a relatively passive role in the decision-making process, and 36.40 % of them had high level of willingness to participate in their medical care decisions. The difference between the types of patients 'decision-making preferences was significant for education level, type of hospital and type of inpatient ward, type of basic insurance (p ≤ 0.05). The mean score of Patients' perceived participation was 62.08 ± 14.92. The difference observed in the mean score of patients' perceived participation in care for gender, type of disease, type of hospital, history of hospitalization, type of basic insurance was significant (p < 0.05). Conclusion: A large percentage of patients in the present study preferred a relatively passive role in decision-making, so it is best for health care providers to provide patients with understandable information about available treatment options and the benefits / risks associated with those choices. Also, the necessary interventions to promote shared decision-making, especially to help female patients and patients with more acute illnesses, as well as to support health care providers to participate in the shared decision-making process with patients, are of particular importance.

scholarly journals “They Should Be Asking Us”: A Qualitative Decisional Needs Assessment for Women Considering Cervical Cancer Screening

2018 ◽  
Vol 5 ◽  
pp. 233339361878363 ◽  
Author(s):  
Brianne Wood ◽  
Virginia L. Russell ◽  
Ziad El-Khatib ◽  
Susan McFaul ◽  
Monica Taljaard ◽  
...  
Keyword(s):  
Health Care ◽  
Cervical Cancer ◽  
Decision Making ◽  
Cancer Screening ◽  
Shared Decision Making ◽  
Cervical Cancer Screening ◽  
Cervical Screening ◽  
Hpv Testing ◽  
Shared Decision ◽  
Care Providers

In this study, we examine from multiple perspectives, women’s shared decision-making needs when considering cervical screening options: Pap testing, in-clinic human papillomavirus (HPV) testing, self-collected HPV testing, or no screening. The Ottawa Decision Support Framework guided the development of the interview schedule. We conducted semi-structured interviews with seven screen-eligible women and five health care professionals (three health care providers and two health system managers). Women did not perceive that cervical screening involves a “decision,” which limited their knowledge of options, risks, and benefits. Women and health professionals emphasized how a trusted primary care provider can support women making a choice among cervical screening modalities. Having all cervical screening options recommended and funded was perceived as an important step to facilitate shared decision making. Supporting women in making preference-based decisions in cervical cancer screening may increase screening among those who do not undergo screening regularly and decrease uptake in women who are over-screened.

Preparing Patients with Early Stage Prostate Cancer to Participate in Clinical Appointments Using a Shared Decision Making Training Video

2021 ◽  
pp. 0272989X2110285
Author(s):  
Karen Scherr ◽  
Rebecca K. Delaney ◽  
Peter Ubel ◽  
Valerie C. Kahn ◽  
Daniel Hamstra ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Decision Making ◽  
Shared Decision Making ◽  
Early Stage ◽  
Controlled Trial ◽  
Treatment Decision ◽  
Shared Decision ◽  
Plain Language ◽  
Training Video ◽  
Video Group

Background Rates of shared decision making (SDM) are relatively low in early stage prostate cancer decisions, as patients’ values are not well integrated into a preference-sensitive treatment decision. The study objectives were to develop a SDM training video, measure usability and satisfaction, and determine the effect of the intervention on preparing patients to participate in clinical appointments. Methods A randomized controlled trial was conducted to compare a plain-language decision aid (DA) to the DA plus a patient SDM training video. Patients with early stage prostate cancer completed survey measures at baseline and after reviewing the intervention materials. Survey items assessed patients’ knowledge, beliefs related to SDM, and perceived readiness/intention to participate in their upcoming clinical appointment. Results Of those randomized to the DA + SDM video group, most participants (91%) watched the video and 93% would recommend the video to others. Participants in the DA + SDM video group, compared to the DA-only group, reported an increased desire to participate in the decision (mean = 3.65 v. 3.39, P < 0.001), less decision urgency (mean = 2.82 v. 3.39, P < 0.001), and improved self-efficacy for communicating with physicians (mean = 4.69 v. 4.50, P = 0.05). These participants also reported increased intentions to seek a referral from a radiation oncologist (73% v. 51%, P = 0.004), to take notes (mean = 3.23 v. 2.86, P = 0.004), and to record their upcoming appointments (mean = 1.79 v. 1.43, P = 0.008). Conclusions A novel SDM training video was accepted by patients and changed several measures associated with SDM. This may be a scalable, cost-effective way to prepare patients with early stage prostate cancer to participate in their clinical appointments. [Box: see text]

scholarly journals Ability of observer and self-report measures to capture shared decision-making in clinical practice in the UK: a mixed-methods study

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e029485
Author(s):  
Denitza Williams ◽  
Adrian Edwards ◽  
Fiona Wood ◽  
Amy Lloyd ◽  
Kate Brain ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Patient Preferences ◽  
Early Stage ◽  
Self Report ◽  
Shared Decision ◽  
Clinical Nurse ◽  
Clinical Nurse Specialists ◽  
Observational Measures ◽  
Breast Care

ObjectivesTo examine how observer and self-report measures of shared decision-making (SDM) evaluate the decision-making activities that patients and clinicians undertake in routine consultations.DesignMulti-method study using observational and self-reported measures of SDM and qualitative analysis.SettingBreast care and predialysis teams who had already implemented SDM.ParticipantsBreast care consultants, clinical nurse specialists and patients who were making decisions about treatment for early-stage breast cancer. Predialysis clinical nurse specialists and patients who needed to make dialysis treatment decisions.MethodsConsultations were audio recorded, transcribed and thematically analysed. SDM was measured using Observer OPTION-5 and a dyadic SureScore self-reported measure.ResultsTwenty-two breast and 21 renal consultations were analysed. SureScore indicated that clinicians and patients felt SDM was occurring, but scores showed ceiling effects for most participants, making differentiation difficult. There was mismatch between SureScore and OPTION-5 score data, the latter showing that each consultation lacked at least some elements of SDM. Highest scoring items using OPTION-5 were ‘incorporating patient preferences into decisions’ for the breast team (mean 18.5, range 12.5–20, SD 2.39) and ‘eliciting patient preferences to options’ for the renal team (mean 16.15, range 10–20, SD 3.48). Thematic analysis identified that the SDM encounter is difficult to measure because decision-making is often distributed across encounters and time, with multiple people, it is contextually adapted and can involve multiple decisions.ConclusionsSelf-reported measures can broadly indicate satisfaction with SDM, but do not tell us about the quality of the interaction and are unlikely to capture the multi-staged nature of the SDM process. Observational measures provide an indication of the extent to which elements of SDM are present in the observed consultation, but cannot explain why some elements might not be present or scored lower. Findings are important when considering measuring SDM in practice.

scholarly journals An integrated knowledge translation approach to develop a shared decision-making strategy for use by Inuit in cancer care: a qualitative study

2019 ◽  
Vol 26 (3) ◽  
Author(s):  
J. Jull ◽  
A. Hizaka ◽  
A. J. Sheppard ◽  
A. Kewayosh ◽  
P. Doering ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Knowledge Translation ◽  
Shared Decision Making ◽  
Cancer Care ◽  
Community Support ◽  
Integrated Knowledge Translation ◽  
Shared Decision ◽  
Care Providers ◽  
Integrated Knowledge

Background In relation to the general Canadian population, Inuit face increased cancer risks and barriers to health services use. In shared decision-making (sdm), health care providers and patients make health care decisions together. Enhanced participation in cancer care decisions is a need for Inuit. Integrated knowledge translation (kt) supports the development of research evidence that is likely to be patient-centred and applied in practice.Objective Using an integrated kt approach, we set out to promote the use of sdm by Inuit in cancer care.Methods An integrated kt study involving researchers with a Steering Committee of cancer care system partners who support Inuit in cancer care (“the team”) consisted of 2 theory-driven phases:■ using consensus-building methods to tailor a previously developed sdm strategy and developing training in the sdm strategy; and■ training community support workers (csws) in the sdm strategy and testing the sdm strategy with community members.Results The team developed a sdm strategy that included a workshop and a booklet with 6 questions for use by csws with patients. The sdm strategy (training and booklet) was finalized based on feedback from 5 urban-based Inuit csws who were recruited and trained in using the strategy. Trained csws were matched with 8 community members, and use of the sdm strategy was assessed during interviews, reported as 6 themes. Participants found the sdm strategy to be useful and feasible for use.Conclusions An integrated kt approach of structured research processes with partners developed a sdm strategy for use by Inuit in cancer care. Further work is needed to test the sdm strategy.

scholarly journals Evaluation of a shared decision-making intervention for dialysis choice at four Danish hospitals: a qualitative study of patient perspective

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e029090 ◽  
Author(s):  
Jeanette Finderup ◽  
Jens Dam Jensen ◽  
Kirsten Lomborg
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Decision Process ◽  
Decision Aid ◽  
Accurate Information ◽  
Decision Making Process ◽  
Shared Decision ◽  
Dialysis Modality ◽  
Individual Interviews ◽  
Informed Preferences

ObjectiveTo evaluate the ‘Shared Decision-making and Dialysis Choice’ (SDM-DC) intervention with regard to patients’ experience and involvement.DesignSemistructured individual interviews and systematic text condensation for data analysis.SettingThe SDM-DC intervention was implemented and evaluated at four different hospitals in Denmark.ParticipantsA total of 348 patients had received the SDM-DC intervention, and of these 29 patients were interviewed.InterventionsSDM-DC was designed for patients facing a choice of dialysis modality. The available modalities were haemodialysis and peritoneal dialysis, either performed by patients on their own or with help from a healthcare professional. The intervention was tailored to individual patients and consisted of three meetings with a dialysis coordinator who introduced a patient decision aid named ‘Dialysis Choice’ to the patient.FindingsThe following were the four main findings: the decision was experienced as being the patient’s own; the meetings contributed to the decision process; ‘Dialysis Choice’ contributed to the decision process; and the decision process was experienced as being iterative.ConclusionsThe patients experienced SDM-DC as involving them in their choice of dialysis modality. Due to the iterative properties of the decision-making process, a shared decision-making intervention for dialysis choice has to be adapted to the needs of individual patients. The active mechanisms of the meetings with the dialysis coordinator were (1) questions to and from the patient, and (2) the dialysis coordinator providing accurate information about the options. The overview of options and the value clarification tool in the decision aid were particularly helpful in establishing a decision-making process based on informed preferences.

scholarly journals Choice of dialysis modality: patients’ experiences and quality of decision after shared decision-making

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Jeanette Finderup ◽  
Kirsten Lomborg ◽  
Jens Dam Jensen ◽  
Dawn Stacey
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Shared Decision ◽  
Dialysis Modality

Person-centered peritoneal dialysis prescription and the role of shared decision-making

2020 ◽  
Vol 40 (3) ◽  
pp. 302-309 ◽  
Author(s):  
Peter G Blake ◽  
Edwina A Brown
Keyword(s):  
Decision Making ◽  
Peritoneal Dialysis ◽  
Shared Decision Making ◽  
Care Delivery ◽  
Shared Decision ◽  
Person Centered Care ◽  
Modern Health Care ◽  
Patient Reported ◽  
Centered Care ◽  
End Stage

Person-centered care has become a dominant paradigm in modern health care. It needs to be applied to people with end-stage kidney disease considering the initiation of dialysis and to peritoneal dialysis (PD) prescription and care delivery. It is relevant to their decisions about goals of care, transplantation, palliative care, and discontinuation of dialysis. It is also relevant to decisions about how PD is delivered, including options such as incremental PD. Shared decision-making is the essence of this process and needs to become a standard principle of care. It requires engagement, education, and empowerment of patients. Patient-reported outcomes and patient-reported experience are also central to person-centered care in PD.

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