scholarly journals Considerations of healthcare professionals in medical decision-making about treatment for clinical end-stage cancer patients

2004 ◽  
Vol 28 (4) ◽  
pp. 351-355 ◽  
Author(s):  
Anna F. van Leeuwen ◽  
Elsbeth Voogt ◽  
Adriaan Visser ◽  
Carin C.D. van der Rijt ◽  
Agnes van der Heide
Keyword(s):  
Decision Making ◽  
Cancer Patients ◽  
Medical Decision Making ◽  
Healthcare Professionals ◽  
Medical Decision ◽  
End Stage

Assessing medical decision making capacity among cancer patients: Preliminary clinical experience of using a competency assessment instrument

2013 ◽  
Vol 13 (6) ◽  
pp. 1529-1533 ◽  
Author(s):  
Tatsuo Akechi ◽  
Toru Okuyama ◽  
Megumi Uchida ◽  
Koji Sugano ◽  
Yosuke Kubota ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Cancer Patients ◽  
Medical Decision Making ◽  
Past History ◽  
Structured Interview ◽  
Assessment Instrument ◽  
Medical Decision ◽  
Dementia Patient ◽  
Decision Making Capacity

AbstractObject:This study investigates the usefulness of the Structured Interview for Competency and Incompetency Assessment Testing and Ranking Inventory (SICIATRI) for cancer patients, which is a structured interview that assesses a patient's competency in clinical practice.Methods:The SICIATRI, originally developed to measure patients' competency to give informed consent, were administered referred cancer patients who needed for assessing medical decision making capacity. The usefulness of the SICIATRI was investigated retrospectively. Recommendation for modification of the SICIATRI for cancer patients if applicable were made by the research team.Results:Among the 433 cancer patients referred for psychiatric consultation, 12 were administered the SICIATRI and all of the administration were conducted without big problems. All patients were 60 years or older. The most common purpose for competency evaluation was to analyze patients' understanding of the anti-cancer treatment proposed by oncologists, followed by their refusal of the treatment. Half of the patients (n = 6) were diagnosed with delirium and three among them were judged as having the most impaired status of a patient's competency. Two patients (17%) were diagnosed with major depression and another two (17%) were mental retardation and each one patient was diagnosed with dementia and past history of alcohol dependence. Among 6 patients without delirium 5 subjects including a dementia patient were judged as fully competent. Total of 5 small potential modifications of the SICIATRI for its use with Japanese cancer patients were recommended.Significance of results:Our experience suggests that the SICIATRI is a useful instrument for psycho-oncology clinical practice.

The impact of “significant others” on breast cancer patients’ treatment decision making.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 20-20
Author(s):  
Suepattra G. May ◽  
Katharine Rendle ◽  
Meghan Halley ◽  
Nicole Ventre ◽  
Allison W. Kurian ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cancer Patients ◽  
Medical Decision Making ◽  
Treatment Decision ◽  
Significant Others ◽  
Medical Decision ◽  
Breast Cancer Patients ◽  
Treatment Decision Making ◽  
The Impact

20 Background: Shared medical decision making (SDM) has been lauded by advocates for its potential to democratize the patient-physician relationship. However, the practice of SDM is still conceived of as largely a dyadic moment that exists between the patient and the physician. Few studies have looked at the role of significant others (spouses, partners, family members and friends) in decision making or considered how discussions and actions outside the consultation room affect a patient’s medical decisions. This prospective study investigated the impact of significant others on the decision making deliberations of newly diagnosed breast cancer patients. Methods: Forty-one newly diagnosed breast cancer patients were interviewed at four critical time points throughout treatment to explore how they deliberated decisions with both care providers and significant others. Surveys assessing HRQOL, role preferences and treatment satisfaction along with EHR abstraction augmented interview data. Grounded theory analysis was used to identify recurrent themes in the qualitative data, and survey data were analyzed using IBM SPSS Statistics 20. Results: Emergent themes from our analysis identified several factors that patients consider when faced with cancer treatment decisions, including 1) presentation of treatment options 2) patient or significant other conflict/concordance with care team recommendations 3) perceived risk of recurrence and 4) short and long term impact of treatment on daily life. Participants stressed the need for clinicians to view patients beyond diagnosis and recognize their larger care network as influential factors in their decision making. Conclusions: Our interviews highlight how the current healthcare delivery structure rarely acknowledges the circles of care that can exert influence on decision making. Lack of attention to non-clinical others can lead to sub-optimal medical decision making because these influences are not adequately understood by clinicians. Findings from this study suggest the need to enhance clinicians’ and researchers’ understanding of the influence of others in patients’ treatment decision making, enabling them to intervene in these practices.

Cancer patients’ awareness and role in family-based medical decision-making mode in Confucian area.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 227-227
Author(s):  
Xing Li ◽  
Min Dong ◽  
Jing-yun Wen ◽  
Li Wei ◽  
Xiao-kun Ma ◽  
...  
Keyword(s):  
Decision Making ◽  
Cancer Patients ◽  
Medical Decision Making ◽  
Family Members ◽  
Mainland China ◽  
Chinese Patients ◽  
Medical Decision ◽  
Family Status ◽  
Positive Role ◽  
Family Based

227 Background: Medical decision making of Chinese patients was family based, which was criticized for the latent moral risk. However, few studies have systematically illustrated the risks of the mode. We aimed to illustrate the determinant of patients’ role in decision making. Methods: A total of 644 adult cancer patients were included in this study between September 1, 2013 and December 31, 2013 from 13 leading general hospitals across China. A questionnaire was give to the oncologists in charge to evaluate each patient concerning the interaction between family and cancer patients, patients’ awareness of disease and participation in medical decision making in mainland China. In this study, the family statuses of patients were ranked as superordinate (one who was the major decision maker in family), equality (one discussed important issues with family members), and subordinate (those who usually don’t be involved in significant family issues). Results: Among the 644 cancer patients, only 125 (19.4%) patients made decision themselves. 291 (45.2%) patients delegated decision making to their family. The rest of 228 (35.4%) patients were involved in decision making. Patients with nonlocal insurance, which meant they traveled to the major cities for advanced medication, were inclined to let their family members make decision for them. Patients’ family status significantly determined their participation in medical decision making. Patients, as superordinate family members, tend to play a positive role in medical decision. By contrast, patients with subordinate role in family continued to play a passive role in medical decision making. Violation of medical recommendation increased according to the severity of patients’ prognosis. The reasons of violation were mainly financial problems. Distrust to doctors presented in merely about 5% of the cases. And conflicts between family members were extremely scarce. Bad news was always hidden from patients, especially for those with incurable disease. Conclusions: Medical decision making of Chinese cancer patients was family based. Patients’ awareness of disease and participation in medical decision making relied on their family status and family financial situation.

Medical decision-making and information needs in end-stage renal disease patients

2003 ◽  
Vol 25 (5) ◽  
pp. 324-331 ◽  
Author(s):  
Angela Orsino ◽  
Jill I Cameron ◽  
Maja Seidl ◽  
David Mendelssohn ◽  
Donna E Stewart
Keyword(s):  
Decision Making ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Information Needs ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Stage Renal Disease ◽  
End Stage

Relationship of Depression and Anxiety to Cancer Patients' Medical Decision-Making

2003 ◽  
Vol 93 (2) ◽  
pp. 323-334 ◽  
Author(s):  
Suni Petersen ◽  
Elisabeth Sherman-Slate ◽  
Jamie L. Straub ◽  
Robert C. Schwartz ◽  
Hanna Frost ◽  
...  
Keyword(s):  
Decision Making ◽  
Cancer Patients ◽  
Information Seeking ◽  
Medical Decision Making ◽  
Depression Scale ◽  
Cancer Prognosis ◽  
Medical Decision ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Rural And Urban

The purpose of this study was to examine the relation of depression and anxiety to cancer patients' medical decision-making. Participants were 79 rural and urban cancer patients undergoing chemotherapy. The four decisional styles of the Decisional Processing Model were the independent variables. Dependent variables were anxiety and depression, measured by Spielberger's State-Trait Anxiety and the Center for Disease Control Depression Scale, respectively. Consistent with the Decisional Processing Model, analysis suggested that patients make medical decisions by information seeking, information processing, advice following, or ruminating. Decisional style did not vary according to type or stage of cancer, prognosis, time elapsed since initial diagnosis, or whether cancer was initial or recurrent. Decisional style did not systematically vary with depression and anxiety suggesting how a person makes decisions is a stable personality trait. Thus, decision-making may follow a cognitive schema. It is likely that patients' decisional styles help to manage anxiety and depression when confronted with life-threatening illness. Implications for informed consent and patients' involvement in decision-making are discussed.

Sign in / Sign up

Export Citation Format

Share Document