scholarly journals Factors associated with decision-making of replacing the temporary coronal restoration after endodontic treatment

2021 ◽  
Vol 21 ◽  
pp. e225580
Author(s):  
Bárbara Scarton Fornari ◽  
Caroline Solda ◽  
Lara Dotto ◽  
Lilian Rigo
Keyword(s):  
Decision Making ◽  
Treatment Decision ◽  
Prevalence Ratio ◽  
Cross Sectional Study ◽  
Endodontic Treatment ◽  
Restorative Material ◽  
Glass Ionomer ◽  
Cross Sectional ◽  
Treatment Decision Making

Aim: This study aimed to evaluate the decision-making by patients to replace temporary restorations with permanent restorations after endodontic treatment and to verify the associated factors and evaluate the quality/integrity of the temporary restorative material within one month. Methods: This is a cross-sectional study using non-probabilistic sampling which analyzed patients after one month of endodontic treatment. The self-administered questionnaire contained sociodemographic, treatment decision-making and endodontic treatment questions. The restoration present in the mouth was evaluated in the clinical oral examination. The Poisson Regression test was used to verify the prevalence ratio. Results: The prevalence failure to perform permanent restorations was 61.1% of patients, and 42.7% reported not having adhered. The reasons are lack of time and not knowing the importance of replacing the restoration with a definitive one. The glass ionomer temporary restorative frequency was higher among those who chose not to replace the temporary restoration with a permanent one (PR=5.19; 95%CI 2.10-12.33). In addition, there was an association between the quality of the restorative material and the type of material, and the best clinical quality of the restoration was statistically associated with glass ionomer and composite resin. Conclusions: The findings show the importance of guidance by the dental surgeon in helping patients decide to replace their temporary restoration.

Financial distress, communication, and cancer treatment decision making: Does cost matter?

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6506-6506 ◽  
Author(s):  
Yousuf Zafar ◽  
Amy Pickar Abernethy ◽  
James A Tulsky ◽  
Peter A Ubel ◽  
Deborah Schrag ◽  
...  
Keyword(s):  
Decision Making ◽  
Cancer Treatment ◽  
Financial Distress ◽  
Private Insurance ◽  
Treatment Decision ◽  
Cross Sectional Study ◽  
Median Income ◽  
Incurable Cancer ◽  
Cross Sectional ◽  
Treatment Decision Making

6506 Background: Financial distress (FD) increases the burden of living with cancer. Even insured patients may experience considerable FD, but little is known about whether patients want to include cost discussions in treatment decision-making. Methods: This is an ongoing cross-sectional study of insured adults with solid tumors on anticancer therapy for ≥1 month. Consecutive patients were surveyed, in person, at a referral center and 3 rural oncology clinics. Participants were asked about FD (via a validated measure), out-of-pocket (OOP) costs, discussion of costs with their doctor, and decision-making. Medical records were reviewed for disease and treatment data. Logistic regression assessed the relationship between FD and cost communication. Results: 119 participants (85% response) had a median age of 60 years (range 27-86). 54% were men, 29% non-white, and 96% completed high school. 81% had incurable cancer. 58% had private insurance. Median income was $50,000/yr. Median OOP costs were $480/mo. The mean FD score (6.7, SD 2.5) corresponded to moderate FD. 19% reported high/overwhelming FD. Overall, 48% (n=57) expressed any desire to discuss costs with their doctor, but only 21% (n=25) had actually done so. Of the 19% with highest FD, 36% (n=8) had discussed costs with a doctor, and 68% (n=15) expressed any desire to discuss costs. The most common reasons for not discussing costs with doctors were: “no problems with costs” (n=47); “want best care regardless of cost” (n=36); and “doctors shouldn’t have to worry about costs” (n=19). Of those who discussed costs with their doctor, 48% (n=12) felt the discussion helped decrease costs. 54% (n=64) wanted their doctors to account for costs in cancer treatment decision-making; 20% (n=24) always wanted costs considered in decision-making. High FD was the only variable associated with greater willingness to discuss costs (adjusted OR 2.81; 95%CI 1.05-7.50; p=0.04). Conclusions: FD was prevalent among insured cancer patients. A large proportion wanted costs discussed with doctors and included in treatment decision-making. Discussing finances may lower costs, but the discussion rarely occurs. Communication and decision-making present a potential focus for intervening on FD.

Treatment decision-making and financial toxicity in metastatic breast cancer.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 97-97
Author(s):  
Clara Wan ◽  
Courtney Williams ◽  
Stacey A. Ingram ◽  
Valerie Lawhon ◽  
Jennifer Young Pierce ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Metastatic Breast Cancer ◽  
Metastatic Breast ◽  
Treatment Decision ◽  
Cross Sectional Study ◽  
Financial Toxicity ◽  
Cross Sectional ◽  
Patient Demographic ◽  
Treatment Decision Making

97 Background: Shared decision-making (SDM), a process where patients partner with their physician to incorporate personal preferences into treatment decisions, is a tenet of high-value healthcare. It is unknown if high-value care associated with SDM manifests in the form of decreased out-of-pocket costs. Therefore, this study analyzes the relationship between patient preference for SDM and financial toxicity in metastatic breast cancer (MBC). Methods: This cross-sectional study utilized surveys of women age ≥ 18 with MBC who received care at two academic hospitals in Alabama between 2017 and 2019. SDM preference and financial toxicity were measured using the Control Preferences Scale and the Comprehensive Score for Financial Toxicity (COST) tool (11-item scale from 0-44, with lower scores indicating worse FT), respectively. Patient demographic and clinical data were abstracted from the electronic medical record. Effect sizes were calculated using Cohen’s d or Cramer’s V. Differences in financial toxicity by SDM preference were estimated using mixed models clustered by site and treating medical oncologist. Results: In 79 women with MBC, 41% preferred SDM, 33% preferred provider-driven decision making, and 22% preferred patient-driven decision making. Patients preferring SDM were more often college educated (48% vs. 40%; V = .15), higher income (52% vs. 44%; V = .09), and privately insured (47% vs. 41%; V = .11). Overall median COST score was 23 (interquartile range 16-30), which varied modestly by SDM preference. After adjusting for patient demographic and clinical characteristics, similar financial toxicity levels were found in patients who preferred SDM (COST 22, 95% confidence interval [CI] 19-25), patient-driven decision making (COST 22, 95% CI 18-26), and provider-driven decision making (COST 24, 95% CI 20-27). Conclusions: Similar levels of financial toxicity were found in patients with differing decision–making preferences regarding their MBC treatment, which may be secondary to lack of discussions about cost. Further research is needed to determine if and how financial toxicity is being identified or included within decision-making.

scholarly journals Quality of Life and Patient Satisfaction after Endodontic Treatment Performed in Three Hospitals in Jeddah, kingdom of Saudi Arabia

2021 ◽  
pp. 84-96
Author(s):  
Ragab Eid Saif Hassan ◽  
Abdulrahman waseem hamid Alhamid ◽  
Abdullah Abdlilwahid Abdullah Alshuaybi ◽  
Abdulaziz Osama Asaad Hamadallah
Keyword(s):  
Quality Of Life ◽  
Saudi Arabia ◽  
Cross Sectional Study ◽  
Endodontic Treatment ◽  
Life Assessment ◽  
Total Degree ◽  
Cross Sectional ◽  
Related Quality ◽  
High Level

Aims: To evaluate the quality of life of patients after endodontic treatment, and their satisfaction toward the endodontic treatment in Jeddah, Saudi Arabia. Methodology: A cross sectional study, was conducted on 300 patients who underwent endodontic treatment from 6 months to a week ago. The study was performed using a self-administered questionnaire. The collected data were analyzed using statistical analysis software SPSS v.26. Results: In the OHRQoL items, the total degree of the oral health-related quality of life assessment was medium with (M = 2.72 out of 5, RII = 54.4%, SD = 0.67), the most affected was "Feeling an excruciating pain in the mouth" with (M = 3.37 out of 5, RII = 67.4%, SD = 0.77), while the least was  " Feeling irritable with others because of the teeth or mouth" with (M = 2.32 out of 5, RII = 46.4%, SD = 1.35). The total degree of the personal satisfaction assessment was high with (M = 3.78 out of 5, RII = 75.6%, SD = 0.67). "Postoperative Pleasantness" was the most satisfied part with (M = 3.86 out of 5, RII = 77.3%, SD = 0.87). Conclusion: This study showed a moderate level of OHRQoL among patients after the endodontic treatment, and a high level of satisfaction among patients toward the endodontic treatment.

scholarly journals Scientific production indicators and researchers training in the Brazilian Collective Health

2019 ◽  
Vol 72 (1) ◽  
pp. 9-18
Author(s):  
Maria Ivanilde Pereira Santos ◽  
Tatiana Fróes Fernandes ◽  
Marise Fagundes Silveira ◽  
Francisco Marcone Veríssimo ◽  
Rafael Amâncio de Oliveira Dias ◽  
...  
Keyword(s):  
Decision Making ◽  
Poisson Regression ◽  
Prevalence Ratio ◽  
Cross Sectional Study ◽  
Scientific Output ◽  
Scientific Production ◽  
Sectional Study ◽  
Cross Sectional ◽  
Training Outcomes ◽  
Gender Characteristics

ABSTRACT Objective: To evaluate the scientific production, generation of patents and researchers training among Brazilian Collective Health professors who were awarded a Pq/CNPq productivity scholarship from 2000 to 2012 and to verify the existence of an association between these production modalities and the characteristics of the professors, such as gender, training and origin. Method: An analytical cross-sectional study was carried out from 2000 to 2012, and the Prevalence Ratio was calculated using Poisson regression. For the statistical analyzes, the SPSS® program was used. Results: Of particular note are regional and institutional concentration, consistent scientific output, important researchers training, and a primordial but still timid generation of patents. We found an association between the "scientific production", "researchers training" outcomes, and the gender characteristics, such as the formation and origin of the Pq professor. Conclusion: These findings can guide the decision-making aimed at the deconcentration of scientific production and researchers training in the Brazilian Collective Health.

HSR19-089: Misperceptions Regarding Palliative and Hospice Care Among Cancer Patients: What Can We Learn from Patient-Reported Treatment Decision Making

2019 ◽  
Vol 17 (3.5) ◽  
pp. HSR19-089
Author(s):  
Sara Hayes ◽  
Brian M. Green ◽  
Shayna Yeates ◽  
Amrita Bhowmick ◽  
Kaitlyn McNamara ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Decision Making ◽  
Palliative Care ◽  
Cancer Care ◽  
Hospice Care ◽  
Treatment Decision ◽  
Treatment Decisions ◽  
Treatment Decision Making ◽  
Diagnosis Of Cancer

Background: Despite NCCN Guidelines and clear definition of palliative care, patients often carry misperceptions about palliative care and how it can be beneficially integrated into a patient’s care plan. In order to better understand the misinformation about palliative and hospice care, this study aims to assess patient-healthcare provider (HCP) communication regarding treatment decisions. Methods: An online survey was conducted with individuals who have had a diagnosis of cancer (n=1,517) to better understand their healthcare experiences as well as the impact their cancer diagnosis had on their quality of life. Measures included agreement scale questions assessing patient information needs surrounding treatment decision making. Open-ended questions where respondents were prompted to provide a written response allowed researchers to further assess patients’ understanding of palliative and hospice care. Responses to agreement-scale questions were evaluated using descriptive statistics. Openended question responses were analyzed using Dedoose qualitative data analysis software. Results: Among patients with a diagnosis of cancer, there were a broad range of patient misperceptions regarding palliative care, hospice care, and how they are used in cancer care. The majority of respondents (81%) stated that their HCP played a role when deciding on their treatment plan. Despite this, only 46% were confident they knew about the treatment’s impact on their daily life, 56% were confident they knew about the potential side effects of treatment, and 57% felt they had all of the information they needed. Themes identified through qualitative analysis include: patient conflation of palliative and hospice care, belief that palliative and hospice care are only relevant to end-of-life decision-making, and uncertainty about whether quality of life can actually be improved. Conclusions: Institutions and HCPs are recommended to integrate palliative care into cancer care. However, as this research shows, oncology patients are often misinformed about the benefits of palliative care. This follows a parallel concern of patients making treatment decisions without optimal information. A potential factor behind this unmet need may be lack of effective communication between patient and HCP. Palliative care may be mentioned by the HCP, but not discussed with enough empathy or depth, leading to patient misunderstanding and lack of inclusion in treatment plans.

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