How does physicians’ decisional conflict influence their ability to address treatment outcomes in a decision-making encounter with an advanced-stage cancer simulated patient? A descriptive study

2020 ◽  
Vol 103 (9) ◽  
pp. 1752-1759
Author(s):  
Yves Libert ◽  
Livia Peternelj ◽  
Delphine Canivet ◽  
Christine Farvacques ◽  
Aurore Liénard ◽  
...  
Keyword(s):  
Decision Making ◽  
Treatment Outcomes ◽  
Descriptive Study ◽  
Decisional Conflict ◽  
Simulated Patient ◽  
Advanced Stage ◽  
Advanced Stage Cancer

Predictors of physicians’ communication performance in a decision-making encounter with a simulated advanced-stage cancer patient: A longitudinal study

2017 ◽  
Vol 100 (9) ◽  
pp. 1672-1679 ◽  
Author(s):  
Yves Libert ◽  
Delphine Canivet ◽  
Catherine Ménard ◽  
Laëtitia Van Achte ◽  
Christine Farvacques ◽  
...  
Keyword(s):  
Decision Making ◽  
Longitudinal Study ◽  
Cancer Patient ◽  
Advanced Stage ◽  
Communication Performance ◽  
Advanced Stage Cancer

scholarly journals Parental decision making involvement and decisional conflict: a descriptive study

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Laura Boland ◽  
Jennifer Kryworuchko ◽  
Anton Saarimaki ◽  
Margaret L. Lawson
Keyword(s):  
Decision Making ◽  
Descriptive Study ◽  
Decisional Conflict ◽  
Parental Decision ◽  
Parental Decision Making

scholarly journals Communicating personalised statin therapy-effects as 10-year CVD-risk or CVD-free life-expectancy: does it improve decisional conflict? Three-armed, blinded, randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e041673
Author(s):  
Nicole E M Jaspers ◽  
Frank L J Visseren ◽  
Yolanda van der Graaf ◽  
Yvo M Smulders ◽  
Olga C Damman ◽  
...  
Keyword(s):  
Decision Making ◽  
Randomised Controlled Trial ◽  
Life Expectancy ◽  
Statin Therapy ◽  
Controlled Trial ◽  
Decisional Conflict ◽  
P Value ◽  
Cvd Risk ◽  
Secondary Outcomes ◽  
Randomised Controlled

ObjectiveTo determine whether communicating personalised statin therapy-effects obtained by prognostic algorithm leads to lower decisional conflict associated with statin use in patients with stable cardiovascular disease (CVD) compared with standard (non-personalised) therapy-effects.DesignHypothesis-blinded, three-armed randomised controlled trialSetting and participants303 statin users with stable CVD enrolled in a cohortInterventionParticipants were randomised in a 1:1:1 ratio to standard practice (control-group) or one of two intervention arms. Intervention arms received standard practice plus (1) a personalised health profile, (2) educational videos and (3) a structured telephone consultation. Intervention arms received personalised estimates of prognostic changes associated with both discontinuation of current statin and intensification to the most potent statin type and dose (ie, atorvastatin 80 mg). Intervention arms differed in how these changes were expressed: either change in individual 10-year absolute CVD risk (iAR-group) or CVD-free life-expectancy (iLE-group) calculated with the SMART-REACH model (http://U-Prevent.com).OutcomePrimary outcome was patient decisional conflict score (DCS) after 1 month. The score varies from 0 (no conflict) to 100 (high conflict). Secondary outcomes were collected at 1 or 6 months: DCS, quality of life, illness perception, patient activation, patient perception of statin efficacy and shared decision-making, self-reported statin adherence, understanding of statin-therapy, post-randomisation low-density lipoprotein cholesterol level and physician opinion of the intervention. Outcomes are reported as median (25th– 75th percentile).ResultsDecisional conflict differed between the intervention arms: median control 27 (20–43), iAR-group 22 (11–30; p-value vs control 0.001) and iLE-group 25 (10–31; p-value vs control 0.021). No differences in secondary outcomes were observed.ConclusionIn patients with clinically manifest CVD, providing personalised estimations of treatment-effects resulted in a small but significant decrease in decisional conflict after 1 month. The results support the use of personalised predictions for supporting decision-making.Trial registrationNTR6227/NL6080.

scholarly journals A population-based evaluation of an intervention to improve advanced stage cancer pain management

2004 ◽  
Vol 28 (4) ◽  
pp. 342-350 ◽  
Author(s):  
Wolfgang Hoffmann ◽  
Heike Munzinger ◽  
Elisabeth Horstkotte ◽  
Eberhard Greiser
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Population Based ◽  
Advanced Stage ◽  
Cancer Pain Management ◽  
Advanced Stage Cancer

Symptom Experiences: Perceptual Accuracy Between Advanced-Stage Cancer Patients and Family Caregivers in the Home Care Setting

2002 ◽  
Vol 20 (16) ◽  
pp. 3495-3507 ◽  
Author(s):  
Michelle M. Lobchuk ◽  
Lesley F. Degner
Keyword(s):  
Home Care ◽  
Cancer Patients ◽  
Family Caregivers ◽  
Care Setting ◽  
Physical Symptoms ◽  
Absolute Difference ◽  
Advanced Stage ◽  
Convenience Sample ◽  
Symptom Experiences ◽  
Advanced Stage Cancer

PURPOSE: This study used a comparative descriptive design to compare family caregivers’ and advanced-stage cancer patients’ perceptions of patients’ multidimensional symptom experiences on presence, frequency, severity, and distress. PATIENTS AND METHODS: A convenience sample of 98 dyads, composed of advanced-stage heterogeneous cancer patients and their caregivers, completed the Memorial Symptom Assessment Scale in the home care setting on a one-time basis. This scale is a 32-item Likert-type scale for assessing the presence, frequency, severity, and distress arising from symptoms in cancer patients. RESULTS: There was confirmation of trends previously described in related studies where, for example, caregivers tend to overreport on symptom experiences. However, the degree of absolute difference between patient and caregiver responses was normally around 1 unit (on a theoretical range of 0 to 4 units). Levels of patient-caregiver agreement were better on more concrete questions related to symptom frequency, severity, and distress than on broad questions related to the presence of a symptom. Patients and caregivers achieved better levels of agreement on physical versus psychological symptoms. CONCLUSION: The findings indicated that family caregivers can provide reasonable proxy or complementary reports on patient symptom experiences of frequency, severity, and distress. However, family caregivers have greater difficulty in achieving high levels of accuracy on psychological versus physical symptoms.

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