scholarly journals Shared Decision Making for Routine Infant Circumcision: A Pilot Study

2015 ◽  
Vol 24 (3) ◽  
pp. 188-200 ◽  
Author(s):  
Teri M. Mitchell ◽  
Claudia Beal
Keyword(s):  
Decision Making ◽  
Pilot Study ◽  
Shared Decision Making ◽  
Accurate Information ◽  
Decision Making Process ◽  
Shared Decision ◽  
Childbirth Education ◽  
Education Class ◽  
High Level ◽  
Routine Infant

ABSTRACTIt is important that expectant parents receive accurate information about the benefits and risks of circumcision as well as the benefits and risks of having an intact foreskin when making a decision about routine infant circumcision (RIC). A pilot study was conducted using the shared decision making (SDM) conceptual model to guide expectant parents through a 3-phase decision-making program about RIC as part of their childbirth education class. The participants showed a high level of preparedness following each of the 3 phases. Preparedness score were highest for those who decided to keep their expected sons’ penises natural. This SDM program was an effective way of guiding expectant parents through the decision-making process for RIC.

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.

A new prognostic and predictive tool to enhance shared decision making in stage III colon cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 4010-4010 ◽  
Author(s):  
Alberto F. Sobrero ◽  
Alberto Puccini ◽  
Qian Shi ◽  
Axel Grothey ◽  
Thierry Andre ◽  
...  
Keyword(s):  
Decision Making ◽  
Colon Cancer ◽  
Shared Decision Making ◽  
Therapeutic Option ◽  
Stage Iii ◽  
Accurate Information ◽  
Decision Making Process ◽  
Shared Decision ◽  
Predictive Tool ◽  
Stage Iii Colon Cancer

4010 Background: Survival outcomes in patients with stage III colon cancer varies widely according to T-N sub-stages. The ability to estimate the benefit of each therapeutic option (surgery alone, fluoropyrimidines alone, oxaliplatin-based doublet for either 3 or 6 months) in each T-N subgroup within stage III, may provide more accurate information helping doctors and patients in the complex shared decision-making process surrounding adjuvant therapy. Methods: Theoutcomedata of 12,834 patients with stage III colon cancer enrolled in the IDEA trial served as our database. Patients were categorized in 16 sub-stages, based on the T-N categories. We created a meta-regression model to predict the expected 3-year DFS within each T-N sub-stage and hence the 5-year DFS rates were projected. We then evaluated the efficacy of each therapeutic option in every sub-stage, working backward by subtraction, using an average of the HRs reported in the pertinent trials publication as conversion factor. Results: Large differences in 3-year DFS rate were observed among the subgroups, ranging from 95% (T1N1a) to 29% (T4N2b) in the overall population. The contribution to outcome of each therapeutic option in this setting varied widely across sub-stages. According to our model, patients with T1N1a cancers have a projected 5-year DFS of 85% with surgery alone. Adjuvant fluoropyrimidine alone results in 4.2% absolute DFS gain; an additional 1.7% and 0.6% gain is seen with oxaliplatin for 3 and 6 months, respectively. Patients with T4N2b cancers show a 4.7% 5-year DFS with surgery alone, and a 7.1%, 5.0%, 2.1% increase with the aforementioned adjuvant options, respectively. Conclusions: The resulting overlay bar graph gives patients and doctors the projected relative benefit of each treatment option and may substantially help the shared decision-making process.

The role of a shared decision-making process in paediatric epilepsy surgery

2021 ◽  
Vol 429 ◽  
pp. 119162
Author(s):  
Michelle Gratton ◽  
Bonnie Wooten ◽  
Sandrine Deribaupierre ◽  
Andrea Andrade
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Epilepsy Surgery ◽  
Decision Making Process ◽  
Shared Decision ◽  
Paediatric Epilepsy

scholarly journals The Association Between Patients' eHealth Literacy and Satisfaction With Shared Decision-making and Well-being: Multicenter Cross-sectional Study (Preprint)

2020 ◽  
Author(s):  
Richard Huan Xu ◽  
Ling-Ming Zhou ◽  
Eliza Lai-Yi Wong ◽  
Dong Wang
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Regression Models ◽  
Well Being ◽  
Shared Decision ◽  
Background Characteristics ◽  
Cross Sectional ◽  
Ehealth Literacy ◽  
High Level ◽  
The Relationship

BACKGROUND Although previous studies have shown that a high level of health literacy can improve patients’ ability to engage in health-related shared decision-making (SDM) and improve their quality of life, few studies have investigated the role of eHealth literacy in improving patient satisfaction with SDM (SSDM) and well-being. OBJECTIVE This study aims to assess the relationship between patients’ eHealth literacy and their socioeconomic determinants and to investigate the association between patients’ eHealth literacy and their SSDM and well-being. METHODS The data used in this study were obtained from a multicenter cross-sectional survey in China. The eHealth Literacy Scale (eHEALS) and Investigating Choice Experiments Capability Measure for Adults were used to measure patients’ eHealth literacy and capability well-being, respectively. The SSDM was assessed by using a self-administered questionnaire. The Kruskal-Wallis one-way analysis of variance and Wilcoxon signed-rank test were used to compare the differences in the eHEALS, SSDM, and Investigating Choice Experiments Capability Measure for Adults scores of patients with varying background characteristics. Ordinary least square regression models were used to assess the relationship among eHealth literacy, SSDM, and well-being adjusted by patients’ background characteristics. RESULTS A total of 569 patients completed the questionnaire. Patients who were male, were highly educated, were childless, were fully employed, were without chronic conditions, and indicated no depressive disorder reported a higher mean score on the eHEALS. Younger patients (SSDM<sub>≥61 years</sub>=88.6 vs SSDM<sub>16-30 years</sub>=84.2) tended to show higher SSDM. Patients who were rural residents and were well paid were more likely to report good capability well-being. Patients who had a higher SSDM and better capability well-being reported a significantly higher level of eHealth literacy than those who had lower SSDM and poorer capability well-being. The regression models showed a positive relationship between eHealth literacy and both SSDM (<i>β</i>=.22; <i>P</i>&lt;.001) and well-being (<i>β</i>=.26; <i>P</i>&lt;.001) after adjusting for patients’ demographic, socioeconomic status, lifestyle, and health status variables. CONCLUSIONS This study showed that patients with a high level of eHealth literacy are more likely to experience optimal SDM and improved capability well-being. However, patients’ depressive status may alter the relationship between eHealth literacy and SSDM. CLINICALTRIAL

scholarly journals Shared decision making for the initiation and continuation of dialysis: a proposal from the Japanese Society for Dialysis Therapy

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kazuyoshi Okada ◽  
Ken Tsuchiya ◽  
Ken Sakai ◽  
Takahiro Kuragano ◽  
Akiko Uchida ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Japanese Society ◽  
Healthcare Management ◽  
Maintenance Hemodialysis ◽  
Decision Making Process ◽  
Healthcare Team ◽  
Shared Decision ◽  
Dialysis Therapy ◽  
Terminal Stage

Abstract Background In Japan, forgoing life-sustaining treatment to respect the will of patients at the terminal stage is not stipulated by law. According to the Guidelines for the Decision-Making Process in Terminal-Stage Healthcare published by the Ministry of Health, Labor and Welfare in 2007, the Japanese Society for Dialysis Therapy (JSDT) developed a proposal that was limited to patients at the terminal stage and did not explicitly cover patients with dementia. This proposal for the shared decision-making process regarding the initiation and continuation of maintenance hemodialysis was published in 2014. Methods and results In response to changes in social conditions, the JSDT revised the proposal in 2020 to provide guidance for the process by which the healthcare team can provide the best healthcare management and care with respect to the patient's will through advance care planning and shared decision making. For all patients with end-stage kidney disease, including those at the nonterminal stage and those with dementia, the decision-making process includes conservative kidney management. Conclusions The proposal is based on consensus rather than evidence-based clinical practice guidelines. The healthcare team is therefore not guaranteed to be legally exempt if the patient dies after the policies in the proposal are implemented and must respond appropriately at the discretion of each institution.

scholarly journals 023 PP: INVOLVING PATIENTS AND CARERS IN RESEARCH: THE EXPERIENCE OF OLDER PEOPLE IN THE SHARED DECISION-MAKING PROCESS IN ADVANCED KIDNEY CARE a

BMJ Open ◽  
2017 ◽  
Vol 7 (Suppl 2) ◽  
pp. bmjopen-2017-016492.41
Author(s):  
N Thomas ◽  
K Jenkins ◽  
S Datta ◽  
R Endacott ◽  
J Kent ◽  
...  
Keyword(s):  
Decision Making ◽  
Older People ◽  
Shared Decision Making ◽  
Decision Making Process ◽  
Shared Decision

Depressed Latinx Older Adults’ Shared Decision-Making Preferences

2021 ◽  
Author(s):  
Sara Romero ◽  
Patrick Raue ◽  
Andrew Rasmussen
Keyword(s):  
Primary Care ◽  
Decision Making ◽  
Puerto Rican ◽  
Shared Decision Making ◽  
Decision Making Process ◽  
Shared Decision ◽  
Medical Conditions ◽  
Depression Severity ◽  
Related Information ◽  
Health Related

The shared decision-making (SDM) model is the optimal patient-centered approach to reduce racial and ethnic health disparities in primary care settings. This study examined decision-making preferences and the desire to be knowledgeable of health-related information of a multiheritage group of depressed older Latinx primary care patients. The primary aim was to determine differences in treatment preferences for both general medical conditions and depression and desire to be knowledgeable of health-related information between older Puerto Rican adults compared to older non-Puerto Rican Latinx adults. We also examined whether depression severity moderated those relationships. A sample of 178 older Latinx patients were assessed on measures of decision-making preferences, information-seeking desires, and depression severity. Regression models indicated depression severity moderated the relationship between Latinx heritage and decision-making preferences that relate to general medical decisions, but not depression treatment. Specifically, Puerto Ricans with high levels of depression preferred to be more active in making decisions related to general medical conditions compared to non-Puerto Rican patients who preferred less active involvement. There was no difference between groups at low levels of depression as both groups preferred to be similarly active in the decision-making process. This investigation adds to the literature by indicating between-group differences within a Latinx older adult sample regarding decision-making preferences and the desire to be informed of health-related information. Future research is needed to identify other sociocultural characteristics that contribute to this disparity between Latinx heritage groups in their desires to participate in the decision-making process with their primary care provider.

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