scholarly journals Caregivers of family members with dementia were involved in a dynamic decision making process to maintain tolerable situations

2000 ◽  
Vol 3 (1) ◽  
pp. 32-32
Author(s):  
A. M. Hughes
Keyword(s):  
Decision Making ◽  
Family Members ◽  
Dynamic Decision Making ◽  
Decision Making Process

Access to residential care in Beijing, China: making the decision to relocate to a residential care facility

2011 ◽  
Vol 32 (8) ◽  
pp. 1277-1299 ◽  
Author(s):  
YANG CHENG ◽  
MARK W. ROSENBERG ◽  
WUYI WANG ◽  
LINSHENG YANG ◽  
HAIRONG LI
Keyword(s):  
Decision Making ◽  
Older People ◽  
Residential Care ◽  
Comparative Method ◽  
Information Access ◽  
Family Members ◽  
Care Facility ◽  
Decision Making Process ◽  
Residential Care Facility ◽  
Geographical Access

ABSTRACTThe demand for residential care by older people is increasing in Beijing as a result of dramatic demographic and socio-economic transformations. Little is known about the way older people access residential care in the context of Beijing. In this research, qualitative data collected from 46 in-depth semi-structured interviews with residential care facility (RCF) managers, older residents, and their family members in six RCFs in Beijing were transcribed and analysed using the constant comparative method. The findings included the following themes: access to residential care as geographical access, information access, economic access, socio-cultural access, and the socio-managerial environment. Geographical access is influenced by location, distance, and the micro-physical environment and amenities of RCFs. Information access refers to the capability to acquire related information on available resources. Economic access is the financial affordability for the resources. Socio-cultural access is affected by individual attitudes and aggregative cultural values on ageing and care of older people. Additionally, the social-managerial environment such as reputations of RCFs, quality of services, and management mechanisms are also important to the decision-making process. All these factors influence older people and their family members’ decision-making process of which RCF to choose. The research provides a multi-perspective analysis of access to residential care and suggestions on improving the accessibility of residential care for older people in Beijing.

Treatment decision-making for older adults with cancer: A qualitative study

2020 ◽  
pp. 096973302094575
Author(s):  
Ni Gong ◽  
Qianqian Du ◽  
Hongyu Lou ◽  
Yiheng Zhang ◽  
Hengying Fang ◽  
...  
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Cancer Patients ◽  
Family Members ◽  
Treatment Decision ◽  
Chinese Society ◽  
Decision Making Process ◽  
Treatment Decision Making ◽  
The Family ◽  
Older Cancer Patients

Background: Independent decision-making is one of the basic rights of patients. However, in clinical practice, most older cancer patients’ treatment decisions are made by family members. Objective: This study attempted to analyze the treatment decision-making process and formation mechanism for older cancer patients within the special cultural context of Chinese medical practice. Method: A qualitative study was conducted. With the sample saturation principle, data collected by in-depth interviews with 17 family members and 12 patients were subjected to thematic analysis. Ethical considerations: The study was approved by the ethics committees of Sun Yat-sen University. All participants provided verbal informed consent after being told their rights of confidentiality, anonymity, and voluntary participation. They had the right to refuse to answer questions and could withdraw at any time. Results: Three themes emerged: (1) complex process; (2) transformation of family decision-making power; and (3) individual compromise. Family members inevitably had different opinions during the long process of treatment decision-making for older cancer patients. The direction of this process could be regarded as an extension of the family power relationship. The patient usually compromised the decision to survive, which was made by family members. Conclusion: This study describes the treatment decision-making process of older cancer patients in the context of Chinese culture. The reasons underlying this process are related to the views on life and death and family values. An individual is a part of the family, which is often seen as the minimal interpersonal unit in Chinese society. It is significant that while emphasizing patient autonomy in the decision-making process, health professionals should also pay attention to the important roles of culture and family.

scholarly journals Dynamic Decision-Making Process of Evacuees during Post-Earthquake Evacuation near an Automatic Flap Barrier Gate System: A Broken Windows Perspective

2021 ◽  
Vol 13 (16) ◽  
pp. 8771
Author(s):  
Yu Song ◽  
Jia Liu ◽  
Qian Liu
Keyword(s):  
Decision Making ◽  
Critical Role ◽  
Emergency Evacuation ◽  
Dynamic Decision Making ◽  
Broken Windows ◽  
Decision Making Process ◽  
Force Model ◽  
Actual Behavior ◽  
Gate System ◽  
Crowd Evacuation

The automatic flap barrier gate system (AFBGS) plays a critical role in building security, but it is more vulnerable to natural hazards than common exits (including power failure, due to earthquakes, and delayed evacuation, due to safety certification, etc.). This article considers a dynamic decision-making process of evacuees during post-earthquake evacuation near an AFBGS. An interesting metaphor, broken windows (BW), is utilized to interpret people’s actual behavior during evacuation. A multi-stage decision-making mechanism of evacuees is developed to characterize the instantaneous transition among three defined stages: Habitual, mild, and radical states. Then, we build a modified three-layer social force model to reproduce the interaction between evacuees based on an actual post-earthquake evacuation. The simulations reveal that BW provides a contextualized understanding of emergency evacuation with a similar effect to the traditional metaphor. An earlier appearance of a mild rule breaker leads to a higher crowd evacuation efficiency. If evacuees maintain the state of broken windows behavior (BWB), the crowd evacuation efficiency can be improved significantly. Contrary to the criminological interpretation, the overall effect of mild BWB is positive, but the radical BWB is encouraged under the command of guiders.

Half the family members of intensive care unit patients do not want to share in the decision-making process: A study in 78 French intensive care units*

2004 ◽  
Vol 32 (9) ◽  
pp. 1832-1838 ◽  
Author(s):  
Élie Azoulay ◽  
Frédéric Pochard ◽  
Sylvie Chevret ◽  
Christophe Adrie ◽  
Djilali Annane ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Family Members ◽  
Decision Making Process ◽  
The Family

scholarly journals Family-owned business in crisis: Introduction of outside manager in the board

2011 ◽  
Vol 8 (2) ◽  
pp. 111-119
Author(s):  
Daria Skidan ◽  
Valeriia Iefymenko
Keyword(s):  
Decision Making ◽  
Financial Crisis ◽  
Corporate Strategy ◽  
Family Members ◽  
Independent Directors ◽  
Executive Power ◽  
Decision Making Process ◽  
Crisis Period ◽  
Managerial Decisions ◽  
A Company

Family-owned business is a company owned and/or controlled by family members. Nowadays FOBs occupy an integral part of world economics and contribute greatly into the world’s GDP. However, financial crisis made FOBs suffer from losses even more than non-family companies. One of the threats connected with family executing the company is decision-making process being influenced by family interests and relations. With this regard, an introduction of the outside manager and vesting him with executive power is proposed for the crisis period to maximize the effect of managerial decisions and corporate strategy. Criteria for the outside manager are similar to independent directors’ criteria.

scholarly journals Shared decision-making in the ICU from the perspective of physicians, nurses and patients: a qualitative interview study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e050134
Author(s):  
Nina Wubben ◽  
Mark van den Boogaard ◽  
JG van der Hoeven ◽  
Marieke Zegers
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Family Members ◽  
Decision Making Process ◽  
Shared Decision ◽  
Icu Patients ◽  
Qualitative Interview Study ◽  
Icu Physicians ◽  
Close Family

ObjectiveTo identify views, experiences and needs for shared decision-making (SDM) in the intensive care unit (ICU) according to ICU physicians, ICU nurses and former ICU patients and their close family members.DesignQualitative study.SettingTwo Dutch tertiary centres.Participants19 interviews were held with 29 participants: seven with ICU physicians from two tertiary centres, five with ICU nurses from one tertiary centre and nine with former ICU patients, of whom seven brought one or two of their close family members who had been involved in the ICU stay.ResultsThree themes, encompassing a total of 16 categories, were identified pertaining to struggles of ICU physicians, needs of former ICU patients and their family members and the preferred role of ICU nurses. The main struggles ICU physicians encountered with SDM include uncertainty about long-term health outcomes, time constraints, feeling pressure because of having final responsibility and a fear of losing control. Former patients and family members mainly expressed aspects they missed, such as not feeling included in ICU treatment decisions and a lack of information about long-term outcomes and recovery. ICU nurses reported mainly opportunities to strengthen their role in incorporating non-medical information in the ICU decision-making process and as liaison between physicians and patients and family.ConclusionsInterviewed stakeholders reported struggles, needs and an elucidation of their current and preferred role in the SDM process in the ICU. This study signals an essential need for more long-term outcome information, a more informal inclusion of patients and their family members in decision-making processes and a more substantial role for ICU nurses to integrate patients’ values and needs in the decision-making process.

What is the role of comorbidity, frailty, and functional status in the decision-making process for older adults with cancer and their family members, oncologists, and family physician?

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 92-92
Author(s):  
Martine Puts ◽  
Schroder Sattar ◽  
Kara McWatters ◽  
Katharine Lee ◽  
Michael Kulik ◽  
...  
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Functional Status ◽  
Family Physician ◽  
Family Members ◽  
Family Physicians ◽  
Treatment Decision ◽  
Decision Making Process ◽  
Theory Approach ◽  
Treatment Decision Making

92 Background: Little is known about the treatment decision making process (TDMP) in older adults (OA) with cancer. The objective of this study is to develop a theoretical framework with the aim to improve the TDMP for this population. Methods: This is a mixed methods multi-perspective longitudinal study. OAs aged > 70 years with advanced prostate, breast, colorectal, or lung cancer, their family members, oncologists and family physicians are invited to participate in individual, semi-structured interviews. Each OA also completes a short survey to characterize their health, functional status, frailty level, decision-making preferences, and satisfaction with the TDMP. The sample is stratified on age (70-79 and 80+) to obtain data saturation for the oldest old. All interviews will be analyzed using the grounded-theory approach. Results: To date, 32 first interviews and 15 second interviews have been completed with 32 older adults, 21 family members and 12 family physicians and 7 cancer specialists. Interviews lasted between 10-60 minutes. Most older adults felt that they should have the final say in the treatment decision, but strongly valued their physician’s opinion. Most participants felt they received enough information, time and support from the oncologist to make their decision. About half the participants went to see their family physician to talk about the diagnosis and plan. Comorbidity and potential side-effects did not play a major role in the decision-making processes for patients and families but it did for oncologists. Family physicians reported they were not involved in treatment decisions, and they preferred more timely information about the patient. Conclusions: This study-in-progress is examining the TDMP from four different perspectives and examining changes over time in the TDMP. Patients and family members were generally satisfied with the treatment decision making process. Final results will be presented at the conference.

scholarly journals Systematic review of qualitative studies on participants in the decision-making process about the location of care of the elderly

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e036551 ◽  
Author(s):  
Gema Serrano-Gemes ◽  
Manuel Rich-Ruiz ◽  
Rafael Serrano-del-Rosal
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Qualitative Methodology ◽  
Data Extraction ◽  
Comparative Method ◽  
Family Members ◽  
The Elderly ◽  
Qualitative Studies ◽  
Decision Making Process ◽  
The Usa

ObjectivesTo understand who are the participants in the decision-making process about the location of care of the elderly.DesignSystematic review of qualitative studies.Data sourcesThe following databases were consulted: Web of Science, MEDLINE, Scopus, CINAHL, PsycINFO and SciELO (from the beginning until 29 November 2017). The bibliographical references in the studies that were finally included in the review were also searched.Study selectionThe studies had to deal with the decision-making process (already experienced by the participants) on the location of care of the elderly (adults who are 65 or older), had to use a qualitative methodology and had to be written in English or Spanish.Data extraction and synthesisA data extraction tool was used. Data analysis was conducted through the constant comparative method from Glaser and Strauss’ grounded theory.Results46 studies were included in this review. Most of them were carried out in the USA, and in 21 of them the study population focused exclusively on the elderly. This review has found that there are many participants, with different roles and degrees of involvement, who may act jointly, separately or sequentially. These participants may be: the elders, family members, professionals and other relevant.ConclusionsThe main result of this review has been the variability found on how this decision is made, even varying the way of acting/perceiving the situation of the involved persons on certain occasions, simply due to the influence of some of the other groups of participants studied. Besides, this review has focused its results on the main participant in this process, the elders and how their family members interact with them when it comes to making this decision. This has allowed relevant results to be obtained about roles and degrees of involvement.PROSPERO registration numberCRD42018084826.

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