scholarly journals Relationship between dementia severity in older women and family caregivers’ preferences for shared decision making about breast cancer screening

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Molly Frank ◽  
Nicole Fowler
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Shared Decision Making ◽  
Family Caregiver ◽  
Standard Of Care ◽  
Shared Decision ◽  
Dementia Severity ◽  
The Relationship

Background/Objective: Mammography is one of the most effective ways to diagnose breast cancer early; however, its perceived benefits are complicated by terminal conditions such as dementia. By undergoing mammography, women with dementia risk treatment complications and false-positive results, which can exacerbate psychological distress. The lack of a standard of care confounds the individual roles of the patient, family caregiver, and physician in the decision-making process. This study evaluates the relationship between dementia severity and family caregiver preferences for shared decision making. Methods: Data were gathered from the Decisions about Cancer screening in Alzheimer’s Disease trial, which uses the Dementia Severity Rating Scale (DSRS) and a revised version of the Control Preferences Scale (CPS) to assess family caregiver preferences for decision-making as a dyad (patient and caregiver) and triad (patient, caregiver, and physician). Two multinomial logistic regression models assessed the relationship between DSRS and CPS categories (active, passive, and collaborative), while controlling for the caregivers’ age, gender, education, relationship to patient, self-perceived income, and race. Both models used the “active” group as the baseline; however, Model 1 examined preferences as a dyad and Model 2 as a triad. Results: Model 1 found a statistically significant association between dementia severity and a collaborative approach (p<0.001), and between dementia severity and a passive approach (p=0.014). For every one-unit increase in DSRS score, the odds of being in the collaborative group decreased by 0.083 and the odds of being in the passive group decreased by 0.085. There was no statistically significant association between dementia severity and decision-making preferences in Model 2. Clinical Significance: The association between dementia severity and family caregiver decision-making preferences supports the need for a standard of care regarding breast cancer screening in women with dementia.

Shared decision making for supporting women’s decisions about breast cancer screening

2020 ◽  
Author(s):  
Paula Riganti ◽  
M. Victoria Ruiz Yanzi ◽  
Camila Micaela Escobar Liquitay ◽  
Karin S Kopitowski ◽  
Juan VA Franco
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Shared Decision Making ◽  
Shared Decision

BPI19-012: Differences in Stakeholder Perspectives Regarding Key Components of Shared Decision-Making for Mammography in Breast Cancer Screening for Women Ages 40–50

2019 ◽  
Vol 17 (3.5) ◽  
pp. BPI19-012
Author(s):  
Lori L. DuBenske ◽  
Sarina B. Schrager ◽  
Terry A. Little ◽  
Elizabeth S. Burnside
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Shared Decision Making ◽  
Average Risk ◽  
Shared Decision ◽  
Delphi Consensus ◽  
Annual Screening ◽  
Core Elements

Background: National health organizations offer contrasting guidelines for women aged 40–49 regarding when to begin and how often to use mammography screening for breast cancer. The ACS recommends average risk women aged 40–44 receive annual screening “if they wish to do so” and annual screening for women aged 45–54. The United States Preventive Services Task Force recommends individualized screening for average-risk women before age 50 advised by risk assessment and shared decision-making (SDM). Clinicians lack guidance on how to conduct and what elements to include in mammography SDM. Our prior work identified core elements via scoping review applied to a modified Delphi consensus process involving patients, primary care physicians (PCP), and healthcare decision scientists (HDS). This study examines stakeholder group differences in endorsing core SDM elements. Methods: The Delphi consensus included 10 patients, 10 PCP, and 10 HDS and fielded 48 items to codify core elements of mammography SDM. A threshold of 80% agreement across all participants was set to establish consensus for retaining or dropping an item. In this study, separate stakeholder groups’ endorsement rates for each item were calculated. Items were deemed to have stakeholder discrepancy if one group differed from the 2 others in either meeting or not meeting the 80% threshold criteria. Results: 16 items (13 retained, 3 dropped in Delphi) had a discrepant group. For all retained items, the discrepant group fell below 80% criteria for retaining. For 2 of the dropped items, discrepant groups achieved threshold for retaining the item. One item was dropped despite most participants voting to retain it (>80%) due to the discrepant group’s rating <80%. Patients rated less importance to educating women about risks and recommendations. PCPs rated lower importance to training PCPs and women for discussions about mammograms and having discussions on a regular basis. HDSs rated greater importance to considering mammogram procedures and costs in SDM. Discussion: Leading healthcare organizations are increasingly recommending SDM in breast cancer screening, among other decisions. Guidelines enumerating core elements of SDM are needed to effectively direct clinicians. This study, by illuminating differences between stakeholder group perspectives, highlights the importance of eliciting varied perspectives in identifying core elements of SDM when informing healthcare practices and policy.

scholarly journals Preliminary Evaluation of a Breast Cancer Screening Shared Decision-Making Aid Utilized Within the Primary Care Clinical Encounter

2021 ◽  
Vol 8 ◽  
pp. 237437352110340
Author(s):  
Lori DuBenske ◽  
Viktoriya Ovsepyan ◽  
Terry Little ◽  
Sarina Schrager ◽  
Elizabeth Burnside
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Shared Decision Making ◽  
Decision Aid ◽  
Clinical Encounter ◽  
Preliminary Evaluation ◽  
Shared Decision ◽  
Decision Conflict

Introduction: The US Preventative Services Task Force recommends shared decision-making (SDM) between women aged 40 and 49 years and their physician regarding timing of mammography screening. This preliminary study evaluates women’s and physician’s satisfaction using Breast Cancer Risk Estimator & Decision Aid (BCARE-DA), a shared decision aid utilized during the clinical encounter, and examines SDM quality for these encounters. Methods: Fifty-three women and their physician utilized BCARE-DA and completed surveys measuring satisfaction with Likert-type and open-ended items and women completed the Decision Conflict Scale. Clinic visit transcripts were evaluated for SDM quality using Observer OPTION-5 and Breast Cancer Screening Decision Core Components Checklist. Results: Women and physicians positively evaluated BCARE-DA. Women had low decision conflict. Physicians demonstrated moderate effort toward SDM, greatest in offering options, and lowest for team talk. Physicians demonstrated 2/3 of core SDM elements in 80% to 100% of encounters. Conclusion: Preliminary findings suggest specific promise for such Decision Aids to facilitate SDM through understanding of personal risks for breast cancer formulated within each screening option, while some SDM elements likely require additional facilitating.

scholarly journals Core Elements of Shared Decision-making for Women Considering Breast Cancer Screening: Results of a Modified Delphi Survey

2020 ◽  
Vol 35 (6) ◽  
pp. 1668-1677
Author(s):  
Kenneth D. Croes ◽  
Nathan R. Jones ◽  
Lori L. DuBenske ◽  
Sarina B. Schrager ◽  
Jane E. Mahoney ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Shared Decision Making ◽  
Delphi Survey ◽  
Shared Decision ◽  
Modified Delphi ◽  
Core Elements

The relationship between health literacy and perceived shared decision making in patients with breast cancer

2019 ◽  
Vol 102 (2) ◽  
pp. 360-366 ◽  
Author(s):  
Hsiu-Nien Shen ◽  
Chia-Chen Lin ◽  
Tammy Hoffmann ◽  
Chia-Yin Tsai ◽  
Wen-Hsuan Hou ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Health Literacy ◽  
Shared Decision Making ◽  
Shared Decision ◽  
The Relationship

scholarly journals Evaluation of the Use of Shared Decision Making in Breast Cancer: International Survey

2021 ◽  
Vol 18 (4) ◽  
pp. 2128
Author(s):  
Marta Maes-Carballo ◽  
Manuel Martín-Díaz ◽  
Luciano Mignini ◽  
Khalid Saeed Khan ◽  
Rubén Trigueros ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Shared Decision Making ◽  
Health Professionals ◽  
Cross Sectional Study ◽  
Shared Decision ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Professional Societies ◽  
New Policies

Objectives: To assess shared decision-making (SDM) knowledge, attitude and application among health professionals involved in breast cancer (BC) treatment. Materials and Methods: A cross-sectional study based on an online questionnaire, sent by several professional societies to health professionals involved in BC management. There were 26 questions which combined demographic and professional data with some items measured on a Likert-type scale. Results: The participation (459/541; 84.84%) and completion (443/459; 96.51%) rates were high. Participants strongly agreed or agreed in 69.57% (16/23) of their responses. The majority stated that they knew of SDM (mean 4.43 (4.36–4.55)) and were in favour of its implementation (mean 4.58 (4.51–4.64)). They highlighted that SDM practice was not adequate due to lack of resources (3.46 (3.37–3.55)) and agreed on policies that improved its implementation (3.96 (3.88–4.04)). The main advantage of SDM for participants was patient satisfaction (38%), and the main disadvantage was the patients’ paucity of knowledge to understand their disease (24%). The main obstacle indicated was the lack of time and resources (40%). Conclusions: New policies must be designed for adequate training of professionals in integrating SDM in clinical practice, preparing them to use SDM with adequate resources and time provided.

Sign in / Sign up

Export Citation Format

Share Document