scholarly journals Refinement of outcome bias measurement in the parental decision-making context

2019 ◽  
Vol 15 (1) ◽  
pp. 41-58 ◽  
Author(s):  
Kaja Damnjanović ◽  
Sandra Ilić ◽  
Irena Pavlović ◽  
Vera Novković
Keyword(s):  
Decision Making ◽  
Neutral Position ◽  
Parental Decision ◽  
Parental Decision Making ◽  
Two Factors ◽  
Health Related ◽  
The Difference ◽  
Outcome Bias ◽  
The Impact ◽  
Negative Outcome

The aim of this study was twofold: one was to test the impact of the involvement on the parental outcome bias, and the second was to refine the measurement of outcome bias, normally reported as the difference between evaluations of a single decision, with different outcomes assigned to it. We introduced the evaluation of a decision without an outcome, to induce theoretically normative evaluation, unbiased by outcome, from which the evaluation shift could be calculated in either direction. To test this refinement in the parental decision-making context, we produced childcare dilemmas with varying levels of complexity, since the rise of complexity induces stronger bias. Complexity was determined by the particular combination of two factors: parental involvement in a decision - the amount of motivation, interest and drive evoked by it – and whether the decision was health-related or not. We presented parents with the decisions for evaluation, followed by a positive and a negative outcome, and without an outcome. The results confirm the interaction between involvement and domain on decision evaluation. Highly involving decisions yielded weaker outcome bias than low-involvement decisions in both health and non-health domain. Results also confirm the validity of the proposed way of measuring OB, revealing that in some situations positive outcomes skew evaluations more than negative outcomes. Also, a highly-involving dilemma followed by negative outcome did not produce significantly different evaluation compared to evaluation of a decision without outcome. Thus, adding a neutral position rendered OB measurement more precise and our involvement-related insights more nuanced.

6. Incapacity II: Children

Medical Law ◽  
2019 ◽  
pp. 302-350
Author(s):  
Emily Jackson
Keyword(s):  
Decision Making ◽  
Medical Treatment ◽  
Best Interests ◽  
Court Cases ◽  
Parental Decision ◽  
Parental Decision Making ◽  
The Difference ◽  
Consent To Medical Treatment ◽  
Academic Debate ◽  
Right To Refuse

All books in this flagship series contain carefully selected substantial extracts from key cases, legislation, and academic debate; providing able students with a stand-alone resource. This chapter discusses children’s medical treatment. It looks at the limits of parental decision-making, and cases in which the courts have overruled parental wishes in order to protect the child’s best interests. Where parents cannot agree with each other about serious medical treatment, or where the treatment is especially controversial, decisions might also need to go before a court. Cases involving withdrawing or withholding life-prolonging treatment are also covered. In relation to mature minors, it discusses the concept of Gillick-competence and the difference that has arisen between the child’s right to consent to medical treatment and her much more limited right to refuse.

scholarly journals Exploring factors influencing health-seeking decisions and retention in childhood cancer treatment programmes: perspectives of parents in Ghana

2016 ◽  
Vol 50 (3) ◽  
pp. 149-156
Author(s):  
Lorna Awo Renner ◽  
Deborah McGill
Keyword(s):  
Decision Making ◽  
Childhood Cancer ◽  
Psychosocial Support ◽  
Social Constructionist ◽  
Health Seeking ◽  
Children With Cancer ◽  
Parental Decision ◽  
Parental Decision Making ◽  
Factors Influencing ◽  
The Impact

Background: Developing countries such as Ghana have very poor childhood cancer survival rates. There is a need to determine reasons for late presentation and treatment abandonment which are major causes of poor survival. Understanding these issues could inform effective strategies for childhood cancer control in resource-constrained settings.Aim: To explore factors influencing parental decision-making for children with cancer in Ghana with regard to health seeking and retention in treatment, in order to provide information that will guide Public Health interventions for childhood cancer control.Method: This exploratory qualitative study was conducted based on an interpretative epistemology using a social constructionist approach. Purposive sampling of parents attending the Paediatric Oncology Unit, Korle Bu Teaching Hospital in Accra, Ghana was undertaken. Twelve semi-structured moderate interviews and two small focus group discussions with a total of seven participants were undertaken. Data analysis was through thematic content analysis.Results: Five major themes emerged. Knowledge and perceptions revealed a total lack of appropriate knowledge prior to diagnosis. Health-seeking behaviour was determined by interplay of individual and environmental factors. Orthodox medical treatment was largely perceived favourably. The impact of cancer on parents and children included psychological, physical and socioeconomic effects. Financial, spiritual and psychosocial support helped in coping. Parents recommended public education and health financing to address the major barriers.Conclusion: Broad social determinants and experiences influence parental decision making for children with cancer. This implies Health Promotion strategies with multi-sectorial involvement will be required for effective implementation of the National Strategy for Cancer Control.Funding: Funded by authorsKeywords: Childhood cancer, parent perspectives, Ghana

511: Factors Involved in Parental Decision-Making for Surgical Correction of Vesicoureteral Reflux

2007 ◽  
Vol 177 (4S) ◽  
pp. 170-170
Author(s):  
Pamela I. Ellsworth ◽  
Katherine Callaghan ◽  
Eileen Gray ◽  
Anthony Caldamone
Keyword(s):  
Decision Making ◽  
Vesicoureteral Reflux ◽  
Surgical Correction ◽  
Parental Decision ◽  
Parental Decision Making

Using messy map interviews to describe and analyse elements pertinent to interviewees

2020 ◽  
pp. 146879412097993
Author(s):  
Maja Nordtug
Keyword(s):  
Decision Making ◽  
Qualitative Research ◽  
Human Papillomavirus ◽  
Human Papillomavirus Vaccination ◽  
Parental Decision ◽  
Mapping Tool ◽  
Parental Decision Making ◽  
Interview Studies

In this article, I introduce and evaluate the use of messy map interviews. Based on messy situational maps, messy map interviews is an interview tool I have developed to facilitate understanding of elements pertinent to interviewees. I present and evaluate how the tool contributes to interview studies that aim to describe and analyse elements pertinent to interviewees. This is done by use of an exemplar of working with messy map interviews, exploring parental decision-making about human papillomavirus vaccination. Based on the results, the study shows that messy map interviews can help keep qualitative research loyal to what interviewees ascribe relevance to. Furthermore, the tool can potentially help nuance the analysis of how elements are understood by interviewees. The article concludes that messy map interviews can be a useful mapping tool that keeps interviewees’ perspectives in focus in interview studies.

Parental decision making regarding consent to randomization on Children's Oncology Group AALL0932

2021 ◽  
Vol 68 (4) ◽  
Author(s):  
Kellee Parker ◽  
Erika Cottrell ◽  
Linda Stork ◽  
Susan Lindemulder
Keyword(s):  
Decision Making ◽  
Oncology Group ◽  
Parental Decision ◽  
Parental Decision Making

Parental Decision-Making for Surgery and Anesthesia in Young Children

2021 ◽  
pp. 019394592110216
Author(s):  
Audrey Rosenblatt ◽  
Michael Kremer ◽  
Olimpia Paun ◽  
Barbara Swanson ◽  
Rebekah Hamilton ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Young Children ◽  
Cognitive Processing ◽  
Emotional Processing ◽  
Theory Analysis ◽  
Parental Decision ◽  
Parental Decision Making ◽  
Health Care Context ◽  
The Relationship

Millions of young children undergo surgery and anesthesia each year, yet there is a lack of scientific consensus about the safety of anesthesia exposure for the developing brain. Also poorly understood is parental anesthesia-related decision-making and how neurotoxicity information influences their choices. The theoretical model of parental decision-making generated in this research explicates this process. Interviews with 24 mothers yielded a theoretical framework based on their narratives developed using a qualitative grounded theory analysis. Five major themes emerged from these interviews: emotional processing, cognitive processing, relationships as resources, the mother/child dyad, and the health care context. Mothers described a non-linear, iterative process; they moved fluidly through emotional and cognitive processing supported by relationships as resources and influenced by the health care context. A key element was the subtheme of the medical translator, an individual who provided context and information. The mother/child dyad grounded the model in the relationship with the child.

Abstract 279: The Impact of Heart Failure on Depression and Quality of Life is Greater in Men than Women

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Rory Hachamovitch ◽  
Brian Griffin ◽  
Alan Klein ◽  
Benjamin Nutter ◽  
Irene Katzan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Demographic Data ◽  
Cardiovascular Assessment ◽  
Related Quality ◽  
Health Related ◽  
The Difference ◽  
The Impact ◽  
The Relationship

Background. Patients (pts) diagnosed with congestive heart failure (HF) have been reported to have more frequent depression and worsened health related quality of life (HRQOL). Although depression is more common in women than men in this condition, the impact of HF on depression and HRQOL in men versus women is unclear. We sought to examine the relationship between pt sex, HF diagnosis, and pt-perceived depression and HRQOL. Methods. Depression (PHQ-9) and HRQOL (EQ5D) data were collected using tablet computers from pts presenting for routine outpatient cardiovascular assessment at our institution between November, 2010 and December, 2011. Demographic, clinical, and historical data was collected as per routine. We examined the association of pt sex and clinical diagnosis of HF with instrument results after adjusting for potential confounding information using mutliple linear regression. Results. Of 3046 pts (age 61±15), 39% were female and 8.7% were diagnosed with HF. Overall, PHQ-9 was greater, and minor or major depression (PHQ-9≥10) was more frequent, in women than men (4.6±4.6 vs. 3.3±4.4; 14.0% vs. 8.9%, both p<0.05) and in HF pts than pts without HF (5.9±5.6 vs. 3.6±4.3, 22.0% versus 9.6%; both p<0.05). Similarly, HRQOL was worse in women than men (EQ-5D 0.80±0.18 vs. 0.87±0.16; p<0.01) and in HF pts than no HF (EQ-5D 0.76±0.18 vs. 0.85±0.17; p<0.01). However, the difference in PHQ-9 between pts with versus without HF was greater in men (6.23±6.06 vs. 3.02±4.06, p<0.01) than women (5.43±4.85 vs. 4.55±4.58, p=0.09). After adjusting for cardiovascular diagnoses, comorbidities, clinical and demographic data, multivariable modeling of PHQ-9 revealed a significant interaction between pt sex and HF diagnosis (p=0.001; see Figure) such that women had greater PHQ-9 scores compared to men without HF, but in the setting of HF, mens' PHQ-9 scores were greater. Modeling of EQ-5D also revealed that after risk-adjustment an interaction between HF diagnosis and sex was present with a similar pattern of findings. Conclusion. Although depression is more frequent and severe in women compared to men, and in pts with versus without HF, HF appears to impact depression severity more in men compared to women.

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