Are Cost-of-Care Conversations Best Practice? A Qualitative Study of Oncologists' Attitudes and Practice

2021 ◽  
pp. OP.21.00042
Author(s):  
Allison M. Scott ◽  
Nancy Grant Harrington
Keyword(s):  
Best Practice ◽  
Descriptive Analysis ◽  
Surgical Oncology ◽  
Cost Of Care ◽  
Optimal Decision ◽  
Individual Interviews ◽  
Qualitative Descriptive ◽  
Optimal Decision Making ◽  
Improve Cost ◽  
Practice Cost

PURPOSE: Patients' desire for cost conversations exceeds the incidence of such conversations, and many oncologists report avoiding cost conversations despite reporting willingness to have them. Our objective was to examine oncologists' attitudes toward cost conversations and how those attitudes affect practice. METHODS: An experienced investigator conducted individual interviews with oncologists practicing in Kentucky. Participants were asked about their attitude toward and experience with cost conversations and their advice for discussing cost with patients. Interview transcripts were analyzed by a four-member team using qualitative descriptive analysis to identify themes. RESULTS: Participants were 32 MDs (male = 68.8%) age 31-77 years who were board-certified in medical oncology (53.1%), surgical oncology (25.0%), or radiation oncology (21.9%). We categorized participants into two groups: (1) those who viewed cost conversations as best practice and reported pursuing such conversations (37.5%) and (2) those who viewed cost conversations as not best practice and reported avoiding them (62.5%). Our analysis revealed three parallel themes for each category: Cost conversation attitudes and practice were based on (1) making good treatment decisions, (2) being a good clinician, and (3) having a good relationship with patients. CONCLUSION: Not all oncologists view cost conversations as best practice. To improve cost conversation attitudes and practice, cost conversations can be framed as a strategic tool that—when used well—fosters optimal decision making, professionalism, and the therapeutic relationship.

scholarly journals “I'm Being Forced to Make Decisions I Have Never Had to Make Before”: Oncologists' Experiences of Caring for Seriously Ill Persons With Poor Prognoses and the Dilemmas Created by COVID-19

2021 ◽  
pp. OP.21.00119
Author(s):  
Chithra R. Perumalswami ◽  
Emily Chen ◽  
Carly Martin ◽  
Susan D. Goold ◽  
Raymond De Vries ◽  
...  
Keyword(s):  
Resource Scarcity ◽  
Optimal Decision ◽  
Ethical Challenges ◽  
Individual Interviews ◽  
Advance Care ◽  
Integrate Technology ◽  
Technology And Communication ◽  
Optimal Decision Making ◽  
Compassionate Communication ◽  
Seriously Ill

PURPOSE: The COVID-19 pandemic has created a new set of problems for clinicians. This study examines the experiences of oncologists providing care to seriously ill persons near the end of life in the context of the COVID-19 pandemic. METHODS: Between January 2020 and August 2020, we conducted semistructured, in-depth individual interviews with 22 purposefully sampled oncologists from practices enrolled in the Michigan Oncology Quality Consortium. Deidentified transcripts of the interviews were examined using thematic analysis. RESULTS: Our respondents described several novel problems created by the COVID-19 pandemic, including: (1) ethical challenges, (2) the need to manage uncertainty—physically and emotionally—on the part of both patients and oncologists, and (3) the difficulty of integrating technology and communication for seriously ill persons. These problems were made more complex by features of the pandemic: resource scarcity (and the need to fairly allocate poor resources), delays in care, high levels of fear, and the increased importance of advance care planning. Nonabandonment served as a way to cope with increased stress, and the use of telemedicine became an increasingly important medium of communication. CONCLUSION: This study offers an in-depth exploration of the problems faced by oncologists as a result of the COVID-19 pandemic and how they navigated them. Optimal decision making for seriously ill persons with cancer during the COVID-19 pandemic must include open acknowledgment of the ethical challenges involved, the emotions experienced by both patients and their oncologists, and the urgent need to integrate technology with compassionate communication in determining patient preferences.

‘I’m being forced to make decisions I have never had to make before’: Oncologists and the conundrums created by COVID-19.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 12001-12001
Author(s):  
Chithra R. Perumalswami ◽  
Emily Chen ◽  
Carly Martin ◽  
Susan Dorr Goold ◽  
Raymond G. De Vries ◽  
...  
Keyword(s):  
Decision Making ◽  
Ethical Dilemmas ◽  
Resource Scarcity ◽  
Optimal Decision ◽  
Individual Interviews ◽  
Integrating Technology ◽  
Qualitative Data Analysis Software ◽  
Technology And Communication ◽  
Optimal Decision Making ◽  
Seriously Ill

12001 Background: The COVID-19 pandemic has created conundrums for physicians. This study examines the experiences of oncologists who engage in complex decision-making regarding the use of chemotherapy in seriously ill persons in the context of the COVID-19 pandemic. Methods: Between January 2020 and August 2020, the authors conducted semi-structured, in-depth individual interviews with 22 purposefully sampled oncologists from practices enrolled in the Michigan Oncology Quality Consortium. Transcripts were double-coded and reconciled by consensus using qualitative data analysis software for thematic analysis. Results: Among the thematic clusters we identified, one was related to conundrums created by the COVID-19 pandemic. In this presentation, we report the results pertaining to three themes within this cluster: (1) the ethical dilemmas faced by oncologists due to the COVID-19 pandemic, (2) the need for both patients and oncologists to manage uncertainty and emotions, and (3) the importance and complexity of integrating technology and communication for seriously ill persons. Oncologists grappled with several conundrums including resource scarcity, resource allocation, delays in care, a duty to promote equity and non-abandonment, high levels of uncertainty and fear, and the importance of advanced care directives and end-of-life care planning. Non-abandonment featured as a coping mechanism for increased stress, and integration of communication with telemedicine was frequent and necessary. Conclusions: This study offers an in-depth exploration of the conundrums faced by oncologists due to the COVID-19 pandemic and how they navigated them. Optimal decision-making for seriously ill persons with cancer during the COVID-19 pandemic must include open acknowledgement of the ethical dilemmas faced, the heightened emotions experienced by both patients and their oncologists, and the urgent need for integrating technology with compassionate communication in determining patient preferences.

MOTIF YANG BERPENGARUH PADA PROSES KEJIWAAN TOKOH SAM DALAM NOVEL SEBENING SYAHADAT KARYA DIVA SR

2020 ◽  
Vol 8 (2) ◽  
pp. 10
Author(s):  
Dandy Ashghor Dawudi ◽  
Kamidjan Kamidjan ◽  
Agus Sulton
Keyword(s):  
Research Method ◽  
Descriptive Analysis ◽  
Research Process ◽  
Cultural Factors ◽  
Qualitative Approach ◽  
Literature Study ◽  
Love Story ◽  
True Value ◽  
Analysis Technique ◽  
Qualitative Descriptive

This research takes the object of Sebening Syahadat by Diva SR, this work is a novel that tells the story of the journey ofa teenager named Sam who is in the process ofsearching for identity. The journey is filled with interesting twits and turns embelissed with a love story that is very suitable if consumed by the younger generation who are learning to find identit. This study aims to reveal the value motives that led Sam’s character in finding his identity, which expected to be a material for reflection for readers, especially young people who are in the process of discovering his identity, the scope of the problem in this study is to reveal the value motives that affect the character’s psyche. Sam is told to have a rascal character.The research method used in this study took a descriptive qualitative approach, data colletion used was a literature study technique with stages of reading, note taking, coding for futher analysis. The analysis technique used is qualitative descriptive analysis technique.The result of the research in this research process indicate that the mental process of Sam’s character influenced by several factors, including: a. Motives in cultural factors (Situasional Factors), b. The motive for love begins with admiration for the attitude of someone who is full of noble values of character, c. The motive of curiosity and fulfillment of his needs for true value.

Politeness Strategies and Social Dimensions in Once Upon A Time Season 1 Movie Series: Sociopragmatics Study

2018 ◽  
Vol 3 (1) ◽  
pp. 18-25
Author(s):  
HENDAR HENDAR ◽  
BUNGA GALUH ANDRETTA TRISNANDI
Keyword(s):  
Social Distance ◽  
Descriptive Analysis ◽  
Social Dimension ◽  
Analysis Method ◽  
Social Dimensions ◽  
Social Distance Scale ◽  
Politeness Strategies ◽  
The Face ◽  
Qualitative Descriptive ◽  
Research Show

The purposes of this research are to find out the types of politeness strategies used to save the face of the characters in Once Upon A Time season 1 and to identify the dominant scale of social dimensions when using politeness strategies in Once Upon A Time season 1. This research uses qualitative-descriptive analysis method and to get the data needed in this research the writer did the following steps: watching the movies, transcribing the speech, searching the data, classifying the data, analyzing the data and drawing a conclusion related to the types of politeness strategies and the dominant scale of social dimensions. The source of the data used is taken from the serial film Once Upon A Time season 1 by Edward Kitsis dan Adam Horowitz. The results of this research show that there are four types of politeness strategies found in the serial film Once Upon A Time season 1. They are 10 data of bald on-record (28,6%), 8 data of positive politeness strategies (22,9%), 13 data of negative politeness strategies (37,1%) and 4 data of off-record consists (11,4%) and the most dominant scale of four social dimension scales is social distance scale 14 data (40%).

PENGEMBANGAN MEDIA PEMBELAJARAN INTERAKTIF TEKNIK PEMESINAN BUBUT

2020 ◽  
Vol 6 (2) ◽  
pp. 169
Author(s):  
Philip Nababan ◽  
Efendi Napitupulu ◽  
R Mursid
Keyword(s):  
Student Learning ◽  
Learning Outcomes ◽  
Interactive Learning ◽  
Descriptive Analysis ◽  
Student Learning Outcomes ◽  
Field Trials ◽  
Student Responses ◽  
Analysis Techniques ◽  
Qualitative Descriptive

Abstrak: Penelitian ini bertujuan untuk: (1) Mengetahui tanggapan siswa terhadap kualitas media pembelajaran interaktif pada pembelajaran Teknik Pemesinan Bubut. (2) Mengetahui keefektifan media pembelajaran interaktif pada pembelajaran Teknik Pemesinan Bubut pada siswa program keahlian Teknik Pemesinan. Jenis penelitian ini adalah penelitian pengembangan. Data tentang kualitas produk pengembangan ini dikumpulkan dengan angket dan dianalisis dengan teknik analisis deskriptif kualiatatif. Hasil penelitian menunjukkan bahwa; (1) uji ahli materi pelajaran Teknik Pemesinan Bubut berada pada kualifikasi sangat baik (88,92%), (2) uji ahli desain pembelajaran berada pada kualifikasi sangat baik (85,21%), (3) uji ahli rekayasa perangkat lunak berada pada kualifikasi sangat baik (84,03%), (4) uji coba perorangan berada pada kualifikasi sangat baik (88,75%), (5) uji coba kelompok kecil berada pada kualifikasi sangat baik (91,35%) dan (5) uji coba lapangan berada pada kualifikasi sangat baik (88,31%). Hasil pengujian hipotesis membuktikan bahwa terdapat perbedaan antara hasil belajar siswa yang menggunakan media pembelajaran interaktif  dengan hasil belajar siswa yang menggunakan buku teks. Hal ini ditunjukkan dengan hasil pengolahan data diperoleh  thitung sebesar 4,68 dan ttabel sebesar 1,67 pada taraf kepercayaan 95 persen. Maka diperoleh bahwa thitung> ttabel. Disimpulkan bahwa  hasil belajar siswa yang menggunakan media pembelajaran interaktif dengan efektifitas sebesar 72,77 %. lebih tinggi dari hasil belajar siswa yang diajar dengan pembelajaran menggunakan buku teks dengan efektifitas sebesar 62,13%. Kata Kunci: media pembelajaran interaktif, teknik pemesinan bubut Abstract: This study aims to: (1) Determine student responses to the quality of interactive learning media on learning Lathe Machining Techniques. (2) Knowing the effectiveness of interactive learning media on learning of Machining Lathe in students of Machining Engineering expertise program. This type of research is development research. Data about the quality of this development product was collected by a questionnaire and analyzed by qualitative descriptive analysis techniques. The results showed that; (1) Lathe machining engineering subject matter expert test is in very good qualification (88.92%), (2) learning design expert test is in very good qualification (85.21%), (3) software engineering expert test is in in very good qualifications (84.03%), (4) individual trials were in very good qualifications (88.75%), (5) small group trials were in very good qualifications (91.35%) and (5 ) field trials are in very good qualifications (88.31%). Hypothesis testing results prove that there are differences between student learning outcomes using interactive learning media with student learning outcomes using textbooks. This is indicated by the results of data processing obtained by tcount of 4.68 and ttable of 1.67 at a confidence level of 95 percent. Then it is obtained that tcount> ttable. It was concluded that student learning outcomes using interactive learning media with an effectiveness of 72.77%. higher than student learning outcomes taught by learning to use textbooks with an effectiveness of 62.13%. Keywords: interactive learning media, lathe machining techniques

Exploration of Creative Thinking Skills of Students in Physics Learning

2020 ◽  
Vol 6 (2) ◽  
pp. 151
Author(s):  
Muhammad Asriadi ◽  
Edi Istiyono
Keyword(s):  
High School Students ◽  
Creative Thinking ◽  
Descriptive Analysis ◽  
Thinking Skills ◽  
School Students ◽  
Cross Sectional ◽  
Physics Learning ◽  
Thinking Ability ◽  
Qualitative Descriptive ◽  
Creative Thinking Ability

This study aims to determine the ability of creative thinking high school students in physics learning, know the form of assessment of creative thinking abilities. The study was conducted at SMAN 6 Yogyakrata. This type of research is a survey with a cross-sectional method that is a survey conducted once and at a time. The subjects were the principals, teachers of physics from SMAN 6 Yogyakrata and 30 grade XI students. observations, interviews, and questionnaires were used as data collection techniques. The data analysis method used was the quantitative-qualitative descriptive analysis. The results showed that the creative thinking ability of class XI MIA 1 students at SMAN 6 Yogyakarta can be said to be in the average and quite good category, although there are some students whose level of creative thinking ability is low. In addition, the form of assessment used by physics teachers has not been effective and accurate enough in assessing students 'creative thinking abilities. So it is recommended to use The Torrance Tests of Creative Thinking (TTCT) in physics learning because it has been proven to be accurate in assessing students' creative thinking abilities.

Peningkatan Kemampuan Guru dalam Menyusun RPP Berbasis Karakter melalui Pendekatan Supervisi Kalaboratif Di SDN 07 Situjuah Gadang Kecamatan Situjuah Limo Nagari

2020 ◽  
Vol 5 (1) ◽  
pp. 17
Author(s):  
Ridwan Ridwan
Keyword(s):  
Learning Process ◽  
Teaching And Learning ◽  
Action Observation ◽  
Descriptive Analysis ◽  
Lesson Plans ◽  
Research Procedure ◽  
Qualitative Descriptive ◽  
The Subject ◽  
Class Teacher ◽  
Planning Action

<span lang="EN-US">The success of teaching and learning activities can be known from the results of teacher performance in preparing character-based lesson plans and implementing them in the teaching and learning process in class. This school action research aims to see whether there is an increase in the ability of teachers in developing character-based lesson plans and their implementation in teaching and learning process. This research uses 2 cycles. The research procedure has four stages of activities</span><span lang="IN"> are</span><span lang="EN-US">, planning, action, observation and evaluation</span><span lang="IN">,</span><span lang="EN-US"> and reflecting. The study was conducted at SDN 07 Situjuah Gadang. The subject of the research is the class teacher and subject teacher, which totals 7 </span><span lang="IN">teachers.</span><span lang="EN-US"> Data processing using qualitative descriptive analysis techniques.</span><span lang="EN-US">Based on the results of data analysis that has been stated, that the data obtained from observing the ability of teachers to prepare character-based lesson plans in cycle I and cycle II there is an increase in the ability of teachers in preparing character-based lesson plans.</span>

Kebijakan Badan Narkotika Nasional Dalam Penanggulangan Narkoba Wilayah Perbatasan

2020 ◽  
Vol 3 (1) ◽  
pp. 20-31
Author(s):  
Novana Veronica Julenta Kareth ◽  
Reni Shintasari
Keyword(s):  
Central Government ◽  
Descriptive Analysis ◽  
Study Data ◽  
Eastern Region ◽  
Analysis Model ◽  
Literature Study ◽  
Qualitative Descriptive ◽  
Multi Stakeholder ◽  
Collection Methods

This paper aims to determine the policies implemented by the Papua National Narcotics Agency against drug trafficking. This article is a qualitative descriptive study. Data collection methods through interviews and literature study. Data analysis using descriptive analysis model. The results showed that the role of BNN Papua is very central in the eastern region and the Indonesian border. The policies that have been planned by BNN with multi-stakeholder have been implemented, but the new modes adopted by the international network vary. The drug subscription policy cannot be carried out by one institution only, it needs to be supported by other government agencies and the community. The need for a serious role for the regional and central government in both preventive efforts and subscription programs in synergy with the Papua Provincial BNN.

Leadership and school self-evaluation in Irish-medium immersion: A roadmap for success

2021 ◽  
pp. 174114322110152
Author(s):  
TJ Ó Ceallaigh ◽  
Aoife Ní Shéaghdha
Keyword(s):  
Quality Indicators ◽  
Cognitive Skills ◽  
Best Practice ◽  
Research Question ◽  
Evaluation Process ◽  
Successful Implementation ◽  
Language And Literacy ◽  
Evaluation Tool ◽  
Self Evaluation ◽  
Individual Interviews

While research on Irish-medium immersion education (IME) has heralded benefits such as cognitive skills, academic achievement and language and literacy development, many studies have also identified challenges to its successful implementation. Immersion-specific research-validated tools can help school leaders navigate the school self-evaluation journey, critically review and evaluate the quality of aspects of their school’s provision and plan for improvement. This paper reports on one theme, leadership, from a larger study, Quality indicators of best practice in Irish-medium immersion (Ó Ceallaigh and Ní Shéaghdha, 2017). Qualitative in nature, the study was guided by the following research question: What are IME educators’ perceptions of best practices in IME?. The study explored 120 IME educators’ perceptions of best practice in IME to inform the development of IME quality indicators. Individual interviews and focus group interviews were utilised to collect data. Data analysis revealed particular themes related to best IME leadership practices. Findings in turn informed the design of an evidence-informed school self-evaluation tool for IME settings. The various functions of the tool will be explored with a particular emphasis on building teaching and leadership capacity in IME through the school self-evaluation process.

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