Review of patient decision-making factors and attitudes regarding preimplantation genetic diagnosis

2018 ◽  
Vol 94 (1) ◽  
pp. 22-42 ◽  
Author(s):  
M.C. Genoff Garzon ◽  
L.R. Rubin ◽  
M. Lobel ◽  
J. Stelling ◽  
L.M. Pastore
Keyword(s):  
Decision Making ◽  
Preimplantation Genetic Diagnosis ◽  
Genetic Diagnosis ◽  
Patient Decision Making ◽  
Patient Decision ◽  
Decision Making Factors

Ethical issues in invasive mechanical ventilation for amyotrophic lateral sclerosis

2010 ◽  
Vol 17 (1) ◽  
pp. 51-63 ◽  
Author(s):  
Yuko Hirano ◽  
Yoshihiko Yamazaki
Keyword(s):  
Decision Making ◽  
Amyotrophic Lateral Sclerosis ◽  
Ethical Issues ◽  
Invasive Mechanical Ventilation ◽  
Patient Decision Making ◽  
Nursing Advocacy ◽  
Patient Decision ◽  
Decision Making Factors ◽  
Herth Hope Index ◽  
Lateral Sclerosis

Currently in Japan, discontinuing an invasive mechanical ventilator (IMV) is illegal; therefore IMV-related decision making is a crucial issue. This study examined IMV decision-making factors and psychological conflict in 50 patients with amyotrophic lateral sclerosis. The Herth Hope Index was used for the assessment of pre- and post-IMV conflict. Interviews identified some decision-making factors: patient’s decision, patient’s and family’s mutual decision, family’s decision, and emergency-induced without patient’s or family’s consent. Participants who experienced no IMV-related regret received sufficient prior IMV education from physicians and nurses, and time for reflection and family consultation. Their hope was similar to their pre-onset levels. Patients who received no prior IMV education accepted treatment as a natural progression. Their hope levels were lower than pre-onset. Those who received only a brief prior IMV explanation rejected the ventilator, experiencing regret if they were given an emergency IMV. Their hope levels were among the lowest. However, some of these patients managed to overcome their regret through being helped by nurses. Sufficient physician explanation and nursing advocacy for autonomous patient decision making are critical for improving hope in this patient group.

INNV-13. UNDERSTANDING FACTORS THAT INFLUENCE THE DECISION OF ACCEPTING TUMOR TREATING FIELDS (TTF) THERAPY

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi107-vi108
Author(s):  
Priya Kumthekar ◽  
Madison Lyleroehr ◽  
Leilani Lacson ◽  
Roger Stupp ◽  
Rimas Lukas ◽  
...  
Keyword(s):  
Social Sciences ◽  
Decision Making ◽  
Influential Factors ◽  
Phase 3 ◽  
Patient Decision Making ◽  
Tumor Treating Fields ◽  
Familial Support ◽  
Patient Decision ◽  
Therapeutic Decisions ◽  
Decision Making Factors

Abstract BACKGROUND Tumor Treating Fields (TTF) Therapy is an FDA-approved therapy in the first line and recurrent setting for glioblastoma. Despite Phase 3 evidence showing improved survival, it is not uniformly utilized despite its availability. This qualitative prospective study interviewed glioblastoma patients to better understand key driving factors for decision making. METHODS Adult glioblastoma patients who were offered TTF and who signed IRB approved consent were included. Patients participated in a one-time recorded interview with the researchers from the Northwestern University Department of Medical Social Sciences and were asked about factors shaping their decision to use or not use TTF. RESULTS 40 patients were enrolled with a mean age of 53 years, 92.5% were white and 60% were male. Of the 33 (82.5%) participants who accepted TTF, 23 (69.7%) reported their physician recommending TTF, 8 (24.2%) reported physician neutrality toward TTF, and 2 (6.1%) said their physician advised against TTF. Among the 7 (17.5%) participants who did not choose TTF, 4 (57.1%) reported physician neutrality, 2 (28.6%) reported that their physician advised against TTF, and 1 (14.3%) reported that their physician recommended TTF. Participants who decided against TTF stated that head shaving, appearing sick, and inconvenience of wearing/carrying the device most influenced their decision. For those choosing to use TTF, the most influential factors were extending life and following their doctor's opinion; other factors included level of familial support and the clinical evidence supporting TTF. DISCUSSION This clinical study was a collaboration with the Medical Social Sciences team to better understand the key factors that drive patient decision making with TTF. Findings suggest that physician support and positive Phase 3 results are among the key decision-making factors. Properly understanding the path to patients’ decision making is crucial in optimizing use of TTF and other therapeutic decisions for glioblastoma patients.

An economic theory of patient decision-making

2005 ◽  
Vol 2 (3) ◽  
pp. 153-164 ◽  
Author(s):  
Douglas O. Stewart ◽  
Joseph P. DeMarco
Keyword(s):  
Decision Making ◽  
Economic Theory ◽  
Patient Decision Making ◽  
Patient Decision
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