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Xiao L, Li T, Lin J, Peng M, Miao J, Zhang L. Determinants of cancer patients' involvement in treatment decision-making based on the COM-B model: A cross-sectional study. PATIENT EDUCATION AND COUNSELING 2023; 114:107795. [PMID: 37244130 DOI: 10.1016/j.pec.2023.107795] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/05/2023] [Accepted: 05/11/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVES Cancer patients' involvement in treatment decision-making is affected by various factors, with the mechanisms not readily understood. This study explores the underlying mechanisms based on the Capability, Opportunity, Motivation and Behavior (COM-B) model and literature review. METHODS A cross-sectional survey was conducted and 300 cancer patients conveniently recruited from three tertiary hospitals validly completed the self-administered questionnaires. Structural equation modeling (SEM) approach was used to test the hypothesized model. RESULTS The findings generally supported the hypothesized model, which could explain 45% of the variance in cancer patients' involvement in treatment decision-making. Cancer patients' health literacy and perceived facilitation of involvement from health professionals had direct and indirect effects on their actual involvement, with the total effect β = 0.594, β = 0.223, P < 0.001, respectively. Patients' views of involvement in treatment decision-making had a direct effect on their actual involvement (β = 0.296, P < 0.001) and completely mediated the relationship between self-efficacy and their actual involvement (β = 0.040, P < 0.05). CONCLUSIONS Findings support the COM-B model's explanatory potential in the context of cancer patients' involvement in treatment decision-making.
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Affiliation(s)
- Lin Xiao
- School of nursing, Southern Medical University, Guangzhou, China.
| | - Ting Li
- School of nursing, Southern Medical University, Guangzhou, China
| | - Jingjing Lin
- School of nursing, Southern Medical University, Guangzhou, China
| | - Meifang Peng
- Department of medical oncology, Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, China
| | - Jingxia Miao
- Department of medical oncology, Nanfang hospital of Southern Medical University, Guangzhou, China
| | - Lili Zhang
- School of nursing, Southern Medical University, Guangzhou, China.
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Marfowaa GD, Friedland DR, Adams JA, Osinski K, Poetker DM. Medial orbital wall decompression: Demographics influencing surgical follow-up and complications: Impacts on follow-up and complications. Am J Otolaryngol 2022; 43:103578. [PMID: 35988365 DOI: 10.1016/j.amjoto.2022.103578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 07/31/2022] [Indexed: 11/01/2022]
Abstract
OBJECTIVE Identify the impact of demographics and social determinants of health on surgical follow-up and complications after medial orbital wall decompression (MOWD) secondary to thyroid associated orbitopathy (TAO). METHODS Demographics and social determinants of health (age, sex, race, insurance status) for 46 patients undergoing MOWD secondary to TAO were correlated with post-operative compliance and surgical complications by chi-square analyses. RESULTS Among 46 patients, 23 were compliant with follow-up. There was no statistically significant difference between compliance and non-compliance based on age (60.25 vs 56.4, p = .41), sex (71.9 % female vs 85.7 % female, p = .31), race (65.6 % white vs 71.4 % white, p = .70) or insurance status (59.4 % private vs 42.9 % private, p = .30). Complications were noted in 50 % of patients of which sinus infection was most common (47.8 % of complications) and epistaxis rare (4.3 % of complications). No correlation was noted between development of complications and compliance (p = .20). Likewise, age, race and insurance status did not correlate with complications. CONCLUSION For patients undergoing MOWD, no correlations with compliance or complication rate were noted with age, sex, race, or insurance status. A larger cohort may be indicated to identify such patterns. The overall complication rate was 50 % and the increased number of visits may have economic impact. KEY POINTS This study provides a unique chance to assess demographic correlates of compliance and complication while controlling for surgeon preference. There was no association between sociodemographics and compliance or complications.
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Affiliation(s)
- Gifty D Marfowaa
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - David R Friedland
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Jazzmyne A Adams
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Kristen Osinski
- Clinical and Translational Science Institute, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - David M Poetker
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, United States of America; Zablocki VA Medical Center, Milwaukee, WI, United States of America.
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Ibrahim KD, Tragesser LA, Soans R, Haddad A, Eddy VJ, McComb J, Keane MG, Whitman IR. Impact of Racial Disparities in Preoperative Cardiovascular Evaluation and Surgical Outcomes in Patients Undergoing Metabolic and Bariatric Surgery: A Retrospective Cohort Analysis. J Am Heart Assoc 2022; 11:e024499. [PMID: 35624077 PMCID: PMC9238690 DOI: 10.1161/jaha.121.024499] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background We investigated preoperative referral patterns, rates of cardiovascular testing, surgical wait times, and postoperative outcomes in White versus Black, Hispanic, or other racial or ethnic groups of patients undergoing metabolic and bariatric surgery. Methods and Results This was a single center retrospective cohort analysis of 797 consecutive patients undergoing metabolic and bariatric surgery from January 2014 to December 2018; 86% (n=682) were Black, Hispanic, or other racial or ethnic groups. White versus Black, Hispanic, or other racial or ethnic groups had similar baseline comorbidities and were referred for preoperative cardiovascular evaluation in similar proportion (65% versus 68%, P=0.529). Black, Hispanic, or other racial or ethnic groups of patients were less likely to undergo preoperative cardiovascular testing (unadjusted odds ratio [OR], 0.56; 95% CI, 0.33–0.95; P=0.031; adjusted for Revised Cardiac Risk Index OR, 0.59; 95% CI, 0.35–0.996; P=0.049). White patients had a shorter wait time for surgery (unadjusted hazard ratio [HR], 0.7; 95% CI, 0.58–0.87; P=0.001; adjusted HR, 0.7; 95% CI, 0.56–0.95; P=0.018). Reduction in body mass index at 6 months was greater in White patients (12.9 kg/m2 versus 12.0 kg/m2, P=0.0289), but equivalent at 1 year (14.9 kg/m2 versus 14.3 kg/m2, P=0.330). Conclusions White versus Black, Hispanic, or other racial or ethnic groups of patients were referred for preoperative cardiovascular evaluation in similar proportion. White patients underwent more preoperative cardiac testing yet had a shorter wait time for surgery. Early weight loss was greater in White patients, but equivalent between groups at 12 months.
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Affiliation(s)
- Kaitlyn D Ibrahim
- Lewis Katz School of Medicine at Temple University Philadelphia PA.,Division of Cardiology Temple University Hospital Philadelphia PA.,Main Line Health Broomall PA
| | | | - Rohit Soans
- Lewis Katz School of Medicine at Temple University Philadelphia PA.,Division of Bariatric Surgery Temple University Hospital Philadelphia PA
| | - Abdullah Haddad
- Lewis Katz School of Medicine at Temple University Philadelphia PA.,Division of Cardiology Temple University Hospital Philadelphia PA
| | - Vikram J Eddy
- Lewis Katz School of Medicine at Temple University Philadelphia PA.,Division of Bariatric Surgery Temple University Hospital Philadelphia PA
| | - Joseph McComb
- Lewis Katz School of Medicine at Temple University Philadelphia PA.,Division of Anesthesiology Temple University Hospital Philadelphia PA
| | - Martin G Keane
- Lewis Katz School of Medicine at Temple University Philadelphia PA.,Division of Cardiology Temple University Hospital Philadelphia PA
| | - Isaac R Whitman
- Lewis Katz School of Medicine at Temple University Philadelphia PA.,Division of Cardiology Temple University Hospital Philadelphia PA
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Xiao L, Miao J, Peng M, Jiang H, Liu S, Liu Y, Zhang L. The effect of health literacy on patient's perceived shared decision-making among Chinese cancer patients. Psychooncology 2021; 31:70-77. [PMID: 34322963 DOI: 10.1002/pon.5777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/16/2021] [Accepted: 07/26/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To explore the relationship between patient's health literacy and perceived shared decision-making (SDM) among Chinese cancer patients. METHODS A cross-sectional study was conducted involving a convenience sample of 458 cancer patients from four public hospitals in Guangzhou, China. Patients' self-reported data were collected using the Health Literacy Management Scale (HeLMS) and the nine-item Shared Decision-Making Questionnaire (SDM-Q-9). Hierarchical multiple regressions, controlling for patient-doctor relationship, social support, sociodemographic and clinical variables were conducted to explore the effect of health literacy on perceived SDM. RESULTS Health literacy itself accounted for 68.0% of the variance in perceived SDM. Higher scores in domains "information acquisition ability," and "communication interaction ability" of HeLMS were significantly associated with a higher level of perceived SDM after controlling the covariates (R2 = 75.7%). CONCLUSIONS Health literacy, especially the information acquisition ability and communication interaction ability, played a prominent role for Chinese cancer patients to be involved in treatment decision making.
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Affiliation(s)
- Lin Xiao
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Jingxia Miao
- Department of Medical Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Meifang Peng
- Department of Medical Oncology, Affiliated Cancer Hospital and Institute, Guangzhou Medical University, Guangzhou, China
| | - Haihua Jiang
- Department of Medical Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Suting Liu
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Yawei Liu
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Lili Zhang
- School of Nursing, Southern Medical University, Guangzhou, China
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De Oliveira GS, Errea M, Bialek J, Kendall MC, McCarthy RJ. The impact of health literacy on shared decision making before elective surgery: a propensity matched case control analysis. BMC Health Serv Res 2018; 18:958. [PMID: 30541541 PMCID: PMC6292056 DOI: 10.1186/s12913-018-3755-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 11/22/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Poor health literacy affects over 90 million Americans. The primary aim of the study was to evaluate a possible association between health literacy and decision conflict in surgical patients. METHODS Patients undergoing a diverse number of elective surgeries were enrolled in the study. Health literacy was measured using the Newest Vital Sign instrument and decision conflict using the low literacy version of the Decision Conflict Scale. RESULTS 200 patients undergoing elective surgeries were included in the study. Patients who had greater health literacy scores had lower decision conflict scores, Spearman's rho = - 0.43, P < 0.001. Following propensity-score matching to account for potential covariates, the median (IQR) decision conflict score was 20 (0 to 40) for patients with poor health literacy compared to 0 (0 to 5) for patients with adequate literacy, P < 0.001. CONCLUSIONS Poor health literacy is associated with greater decision conflict in patients undergoing elective surgical procedures. Strategies should be implemented to minimize decision conflict in poor health literacy patients undergoing elective surgical procedures.
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Affiliation(s)
- Gildasio S. De Oliveira
- Department of Anethesiology, Alpert School Of Medicine, Brown University, 593 Eddy Street, Davol 129, Providence, Rhode Island USA
- Department of Health Services Research, Practice and Policy, School of Public Health, Brown University, Providence, Rhode Island USA
- Department of Surgery, Alpert School of Medicine, Brown University, Providence, Rhode Island USA
| | - Martin Errea
- Department of Radiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois USA
| | - Jane Bialek
- University of Illinois at Chicago, School of Medicine, Chicago, Illinois USA
| | - Mark C. Kendall
- Department of Anethesiology, Alpert School Of Medicine, Brown University, 593 Eddy Street, Davol 129, Providence, Rhode Island USA
- Department of Surgery, Alpert School of Medicine, Brown University, Providence, Rhode Island USA
| | - Robert J. McCarthy
- Department of Anesthesiolgy, Rush University Medical Center, Chicago, Illinois USA
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Kendall MC, Castro-Alves LJ. Comments on "Added Healthcare Charges Conferred by Smoking in Outpatient Plastic Surgery". Aesthet Surg J 2018; 38:5001938. [PMID: 29800082 DOI: 10.1093/asj/sjy058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Mark C Kendall
- Department of Anesthesiology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI
| | - Lucas J Castro-Alves
- Department of Anesthesiology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI
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