scholarly journals Physician, Patient, and Contextual Factors Affecting Treatment Decisions in Older Adults With Cancer and Models of Decision Making: A Literature Review

2011 ◽  
Vol 39 (1) ◽  
pp. E70-E83 ◽  
Author(s):  
Joseph D. Tariman ◽  
Donna L. Berry ◽  
Barbara Cochrane ◽  
Ardith Doorenbos ◽  
Karen G. Schepp
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Literature Review ◽  
Contextual Factors ◽  
Treatment Decisions ◽  
Factors Affecting ◽  
Physician Patient

Physician-Identified Factors Affecting Patient Participation in Reaching Treatment Decisions

2008 ◽  
Vol 26 (10) ◽  
pp. 1724-1731 ◽  
Author(s):  
Heather L. Shepherd ◽  
Martin H.N. Tattersall ◽  
Phyllis N. Butow
Keyword(s):  
Decision Making ◽  
Patient Involvement ◽  
Treatment Options ◽  
Treatment Decision ◽  
Treatment Decisions ◽  
Treatment Team ◽  
Factors Affecting ◽  
Written Information ◽  
Third Person ◽  
Insufficient Time

Purpose Cancer physicians report high comfort with shared decision making but a lower frequency of using this approach in practice. Information regarding physicians’ perceptions of what helps and what hinders patient involvement in decision making may facilitate understanding of this discrepancy. Methods We surveyed 604 Australian cancer physicians treating breast, colorectal, gynecologic, hematologic, or urologic cancer to investigate barriers and facilitators to reaching treatment decisions with their patients and their support of strategies to encourage patient involvement and reflection on treatment options. Factor analysis and regression analyses were used to investigate relationships between variables and identify predictors of greater reporting of barriers to sharing treatment decisions with patients. Results Insufficient information at the first consultation (28.9%) and insufficient time (28.4%) were the most frequently reported barriers to reaching treatment decisions with patients. Multivariate analysis revealed that less experienced physicians more commonly reported system barriers (P = .00). Patients trusting their physician and being accompanied at the consultation were most helpful to reaching a treatment decision. Providing written information about treatment options, making a further appointment to reach a decision, encouraging the patient to speak with their family physician and treatment team, and the presence of a third person during the consultation were felt to encourage involvement and reflection on treatment decisions. Conclusion Cancer physicians experience difficulties when reaching treatment decisions with their patients. Interventions and strategies that physicians support are required to enhance patient involvement in reaching a treatment decision.

scholarly journals How does servitisation affect supply chain circularity? – A systematic literature review

2019 ◽  
Vol 33 (4) ◽  
pp. 703-728 ◽  
Author(s):  
Carl Kühl ◽  
Michael Bourlakis ◽  
Emel Aktas ◽  
Heather Skipworth
Keyword(s):  
Supply Chain ◽  
Literature Review ◽  
Conceptual Model ◽  
Systematic Literature Review ◽  
Business Models ◽  
Contextual Factors ◽  
Resource Efficiency ◽  
Content Type ◽  
Factors Affecting ◽  
The Relationship

Purpose The purpose of this paper is to test the link between servitisation and circular economy by synthesising the effect of product-service systems (PSS) on supply chain circularity (SCC). Design/methodology/approach Following a systematic literature review methodology, the study identified 67 studies and synthesised them using content analysis. Findings A conceptual model is developed illustrating how PSS business models impact SCC through increased product longevity, closure of resource loops and resource efficiency. It also identifies six contextual factors affecting the implementation of SCC including: economic attractiveness of SCC; firm sustainability strategy; policy and societal environment; product category; supply chain relationships; and technology. Research limitations/implications The conceptual model proposes that SCC increases with servitisation. It also proposes that the main circularity effect stems from increased product longevity, followed by closed resource loops and finally resource efficiency. The model is deduced from the literature by using secondary data. Practical implications The review provides practitioners with a framework to increase SCC through PSS business models. It also gives insight into the various contextual factors that may affect how a manufacturer’s servitisation strategy contributes to SCC. Originality/value This review contributes to the understanding of the relationship between servitisation and SCC by synthesising the different effects that exist. Moreover, it creates new knowledge by identifying a range of contextual factors affecting the relationship between PSS and SCC.

scholarly journals Addressing funding issues for Danish mental health NGOs

2018 ◽  
Vol 17 (2) ◽  
pp. 79-89
Author(s):  
Nawal Farhat Aguilar ◽  
Zaza Nadja Lee Hansen
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Literature Review ◽  
Key Factors ◽  
Content Type ◽  
Factors Affecting ◽  
Non Governmental Organizations ◽  
Decision Making Framework ◽  
Optimal Approach

Purpose Research has shown that non-governmental organizations (NGOs) often fail to appreciate that in their market, donors represent clients. Moreover, the unstable income characteristics of NGOs emphasize the importance of conducting market analysis specific to such organizations. The purpose of this paper is to identify key factors that influence fundraising success for mental health NGOs and determine the most advantageous fundraising approach based on a mixed-methods study that encompass a literature review, two surveys and a case study. Design/methodology/approach Based on a structured literature review, the most important factors affecting NGO fundraising are unified into a decision-making framework. This framework is tested using a triangulation approach by combining quantitative and qualitative methods. The former based on a general survey and the latter based on a case study. Findings The results highlight 15 key factors determining the optimal approach for mental health NGOs when fundraising in Denmark. Practical implications The decision-making framework can be used to assess the most advantageous fundraising approach based on a variety of internal and external circumstances. Originality/value While private firms develop exhaustive market analyses, NGOs often lack analyses to cope with fluctuating environments and changing customer needs. This paper addresses this gap by identifying key factors that determine an optimal fundraising approach and proposes a novel decision-making framework for practitioners.

scholarly journals Aging and Decision Making: Socio-Emotional and Contextual Factors

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 557-557
Author(s):  
JoNell Strough ◽  
Corinna Loeckenhoff ◽  
Susan Charles
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Age Differences ◽  
Risk Taking ◽  
Contextual Factors ◽  
Emotional Responses ◽  
Later Life ◽  
Future Research ◽  
Behavioral Risk ◽  
Younger Adults

Abstract Maintaining sound decision-making skills in later life is a key concern in the face of population aging. The four presentations in this symposium highlight the importance of considering socio-emotional and contextual factors when investigating adult age differences in decision making. Together, they show that features of decision contexts such as the way information is presented, along with social relationships and emotional responses, have distinct implications for understanding age effects in decision-related processing and outcomes. Drawing from fuzzy trace theory, Nolte, Löckenhoff and Reyna showed that gist-based (“good,” “extremely poor”) versus verbatim information (exact numbers) was differentially appealing to younger and older adults, with older adults seeking more gist information than verbatim information. Young and Mikels investigated older and younger adults’ integral emotional responses to a behavioral risk-taking task. Younger adults experienced more anger and less contentment than older adults. These emotions differentially predicted risk taking in the two groups. Seaman, Christensen, Senn, Cooper, and Cassidy found age differences in learning about the trustworthiness of social partners. Older adults showed less learning relative to younger adults and invested less with trustworthy partners and more with untrustworthy partners. Smith, Strough, Parker and Bruine de Bruin found that older age, perceiving better decision-making ability than age peers, and perceiving declines in ability over time, were associated with lesser preferences for making decisions with others. In her discussion, Charles will integrate these findings with existing research on aging and decision making and offers directions for future research.

scholarly journals Cardiologists’ experiences and perceptions of patient involvement and communication related to shared decision-making regarding atrial fibrillation treatment

2017 ◽  
Vol 14 (1) ◽  
pp. 39-50 ◽  
Author(s):  
Eleni Siouta ◽  
Ulla Hellström Muhli ◽  
Bjöörn Fossum ◽  
Klas Karlgren
Keyword(s):  
Atrial Fibrillation ◽  
Decision Making ◽  
Content Analysis ◽  
Patient Involvement ◽  
Qualitative Content Analysis ◽  
Treatment Decisions ◽  
Shared Decision ◽  
Supportive Communication ◽  
Physician Patient Communication ◽  
Physician Patient

Objective: To feel involved in decisions about atrial fibrillation (AF) treatment, patients need supportive communication from cardiologists. Shedding light on cardiologists’ perceptions of patient involvement in AF care settings is thus of importance. We examine (1) how cardiologists describe patient involvement and communication related to shared decisionmaking regarding AF treatment, and (2) their perceptions of efforts to involve patients in the treatment decisions. Methods: Ten cardiologists were interviewed in four Swedish hospitals. A qualitative content analysis was performed on the interview data. Results: Cardiologists’ perceptions of patient involvement in treatment decisions are framed in terms of (1) ideology, (2) experience, and (3) responsibility. Conclusion: By taking into account patients’ feelings in the consultations, and by actively encouraging patients to be involved, the cardiologists contributed to patient involvement. Practice Implications: One key to improving compliance with legislation aimed at increasing patient involvement in treatment decisions could lie in paying attention to physician–patient communication and the conditions for patient involvement in decision-making about treatment.

scholarly journals Factors Impacting Treatment Decision Making in Older Adults With Indolent Non-Hodgkin Lymphoma

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 514-515
Author(s):  
Kelly Trevino ◽  
Peter Martin ◽  
John Leonard
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Shared Decision Making ◽  
Initial Treatment ◽  
Treatment Decision ◽  
Treatment Decisions ◽  
Shared Decision ◽  
Younger Adults ◽  
Treatment Decision Making

Abstract Indolent non-Hodgkin lymphomas (NHL) are among the most common lymphomas and up to two-thirds of diagnoses are made in older adults (age≥65 years). Initial treatment options include cancer-directed therapy or active monitoring by the oncologist for disease progression. Despite the disparate nature of these treatments, the factors impacting older adults’ treatment decisions are unknown. This study examines the reasons older adults chose their initial treatment, factors influencing this decision, shared decision-making preferences, and differences in these factors relative to younger adults (age<65 years). Adult patients (≥21 years) with a new diagnosis of indolent NHL in the past six months completed electronic self-report measures. The final sample consisted of 86 patients; 43.0% (n=37) were older adults. Over two-thirds of older adults (n=25, 67.6%) were being monitored by their oncologist with no age differences in current treatment (p=.55). Most older adults chose their treatment plan to “maximize my long-term health” (n=24, 64.9%) which did not differ from younger adults (p=.77). The primary factors impacting older adults’ treatment decisions were their doctor’s recommendation (M=3.92, SD=.28, Range=0-4) and their personal preference (M=2.88, SD=1.68, Range=0-4). Factors impacting treatment decisions did not differ by age (all p’s>.05). Most older adults (n=25, 69.4%) expressed a preference for shared decision-making with their oncologist which did not differ from younger adults (p=.17). Treatment planning for older adults should consider long-term health, consistent with older adults’ values. Older adults may view treatment decision-making similarly to younger adults; assumptions about patients’ values and decision-making preferences based on age are likely inappropriate.

Participation of Chronically Ill Older Adults in Their Life-Prolonging Treatment Decisions: Rights and Opportunity

1998 ◽  
Vol 17 (1) ◽  
pp. 1-23 ◽  
Author(s):  
Sarah Shidler
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Decision Making ◽  
Clinical Practice ◽  
Older Adult ◽  
Chronically Ill ◽  
Treatment Decisions ◽  
The Individual ◽  
The Right ◽  
Legal Guidelines

ABSTRACTThe right of the individual to participate in her life-prolonging treatment decisions, either as a decision maker or by having her treatment wishes used as a decision-making criterion, is the result of an evolution in legal guidelines over the last two decades. Although necessary, these legal guidelines are however not sufficient to assure the individual's opportunity to participate. For the chronically ill older adult residing in a health care institution, the opportunity to participate in decisions concerning life-prolonging treatments implicitly depends on the effective communication among three key actors (the individual, her physician, and her proxy). The necessity of this communication has important implications for clinical practice and future empirical research.

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