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Wang Y, Wu Y, Hu R. Decision-making trade-offs: A classic grounded theory study of Chinese acute leukaemia patients and their family caregivers across the trajectory of illness. J Clin Nurs 2023; 32:7834-7845. [PMID: 37614047 DOI: 10.1111/jocn.16851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/12/2023] [Accepted: 08/02/2023] [Indexed: 08/25/2023]
Abstract
AIM AND OBJECTIVES To identify the main concern of patients with acute leukaemia and their family caregivers in the process of coping with the disease and to determine how patients and their family caregivers address these concerns on an ongoing basis. BACKGROUND Acute leukaemia is a progressive disease that may lead to physical problems and mental stress in patients. It also affects the psychological well-being and quality of life of family caregivers. Nevertheless, few studies explore the behavioural pattern across the trajectories of illness in Chinese patients with acute leukaemia and their family caregivers. DESIGN Grounded theory. METHODS Theoretical sampling was performed to collect 14 sets of secondary data from Bilibili platform, literature, articles from WeChat official account, press releases and documentary. A total of 29 participants were selected to participate in semistructured interviews from the haematology department of a tertiary care hospital in Fuzhou, Fujian Province from January 2021 to November 2021. Data collection and analysis were conducted in a synchronous iterative manner until theoretical saturation was reached. Data analysis included open coding, selective coding and constant comparison, et al. The CCOREQ checklist was utilised. RESULTS This study discovered the main concern (i.e. seeking survival) and main behavioural pattern of how patients with acute leukaemia and their family caregivers addressed this issue. Three decision-making strategies, 'responding' 'accommodating' and 'resisting' also emerged. CONCLUSIONS This study explored the behavioural pattern of patients with acute leukaemia and their family caregivers in the process of coping with disease. The study found that the main concern of patients with acute leukaemia and their family caregivers, and provided a theoretical basis for disease management and nursing interventions for them in the future. RELEVANCE TO CLINICAL PRACTICE The findings of this study contribute to nursing knowledge, practice in the field of patients' participation in decision-making. PATIENT OR PUBLIC CONTRIBUTION Due to the characteristics of grounded theory (no presupposition of research questions), the interviews in this study mainly focus on theory generation. Participants were not asked to assess the burden of the intervention and the time required to participate in the study, as interviews were conducted for theory generation. This study may assist patients and family caregivers in obtaining better understand and adapt to changes across the trajectory of illness, as well as to promote public destigmatisation of acute leukaemia and reforms in family-hospital-community diversified care.
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Affiliation(s)
- Ying Wang
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Yong Wu
- Department of Hematology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Rong Hu
- The School of Nursing, Fujian Medical University, Fuzhou, China
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2
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Fadem S. Investigating and Supporting Patient and Caregiver Sensemaking in Complex Medical Decisions Using Participatory Design. MDM Policy Pract 2023; 8:23814683231164988. [PMID: 37077898 PMCID: PMC10107376 DOI: 10.1177/23814683231164988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 02/20/2023] [Indexed: 04/21/2023] Open
Abstract
Background. Patients and caregivers facing complex health decisions must make sense of unfamiliar, emotionally challenging information and experiences. For patients with hematological malignancy, bone marrow transplant (BMT) may be the best chance for a cure but has significant risk of morbidity and mortality. This study aimed to investigate and support patient and caregiver sensemaking as they consider BMT. Methods. Ten BMT patients and 5 caregivers engaged in remote participatory design (PD) workshops. Participants drew timelines of their memorable experiences leading up to BMT. Then, they used transparency paper to annotate their timelines and design improvements to this process. Results. Thematic analysis of drawings and transcripts revealed a 3-phase sensemaking process. In phase 1, participants were introduced to BMT and understood it as a possibility, not an inevitability. In phase 2, they focused on meeting prerequisites including remission and donor identification. Participants came to believe they needed transplant, consequently describing BMT not as a decision between viable options, but that transplant was their "only chance" for survival. In phase 3, participants attended an orientation detailing the extensive risks of transplant, leading to anxiety and doubt. Participants designed solutions that provided reassurance to those grappling with the life-altering impacts of transplant. Conclusions. For patients and caregivers navigating complex health decisions, sensemaking is a dynamic, ongoing process that affects expectations and emotional well-being. Interventions targeting reassurance alongside risk information can alleviate emotional impact and facilitate expectation development. The integration of PD and sensemaking methodologies enables participants to create holistic, tangible representations of experiences while empowering stakeholder engagement in intervention design. This method could be applied to other complex medical contexts to understand lived experiences and develop effective support interventions. Highlights Bone marrow transplant patients and caregivers experienced an evolving, emotionally challenging process of gradually understanding the transplant procedure and its risks.The solutions that participants designed centered on providing reassurance alongside risk information, suggesting future interventions could target emotional support as patients attempt to meet prerequisites and grapple with the risks of the potentially curative procedure.By viewing the challenges of complex medical decisions in terms of sensemaking and applying visual methods such as participatory design, researchers can facilitate expression of the dynamic, multifaceted, emotional components of experience and empower stakeholder involvement in intervention design.
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Affiliation(s)
- Sarah Fadem
- Sarah Fadem, Rutgers Robert Wood Johnson Medical
School, 1 Robert Wood Johnson Place, Piscataway, NJ 08854-5635, USA;
()
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3
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Morikawa M, Shirai Y. Qualitative Analysis of the Roles of Physicians and Nurses in Providing Decision Support to Patients With Relapsed or Refractory Leukemia and Lymphoma. Cancer Control 2022; 29:10732748221131003. [PMID: 36268680 PMCID: PMC9597203 DOI: 10.1177/10732748221131003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction This study examined the roles of hematologists and other professionals in
providing decision support to patients with relapsed or refractory leukemia
and lymphoma. Methods This was a qualitative study using in-depth semi-structured interviews
involving 11 hematologists in Japan. Result We identified 7 categories related to the roles of hematologists in providing
direct decision support to patients: (1) preparing patients before informed
consent, (2) selecting the information to convey, (3) choosing a method for
conveying this information, (4) respecting the intentions of patients and
their families, (5) directing decision-making and considering fairness, (6)
considering the emotional aspects of patients and their families, and (7)
providing support after discussing treatment options. We also identified the
following 5 subcategories related to the roles of hematologists in
multidisciplinary collaboration: (1) communicating with other professionals,
(2) gathering information from them, (3) providing information to them, (4)
managing the entire medical team, and (5) encouraging nurses to actively
participate with patients throughout the decision-making process. Conclusion Through content analysis, the hematologist’s direct role in decision-making
was extracted as preparation and consideration in situations where
information about decision-making is communicated, and emotional support
after the information is communicated. In addition, active participation in
discussions, sharing information about the patient’s situation and relevant
discussions, and emotional support as the hematologist’s expected roles in
other professions were extracted. The results therefore suggest that a
multidisciplinary team is needed to share information and provide
multidimensional support to patients.
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Affiliation(s)
| | - Yuki Shirai
- Department of Human Health
Sciences, Kyoto
University, Kyoto, Japan,Yuki Shirai, Department of Human Health
Sciences, Kyoto University, 53 Shougoinkawaharacho, Kyoto Sakyo-ku, 606-8507
Kyoto, Japan.
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4
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Keij SM, de Boer JE, Stiggelbout AM, Bruine de Bruin W, Peters E, Moaddine S, Kunneman M, Pieterse AH. How are patient-related characteristics associated with shared decision-making about treatment? A scoping review of quantitative studies. BMJ Open 2022; 12:e057293. [PMID: 35613791 PMCID: PMC9174801 DOI: 10.1136/bmjopen-2021-057293] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES To identify what patient-related characteristics have been reported to be associated with the occurrence of shared decision-making (SDM) about treatment. DESIGN Scoping review. ELIGIBILITY CRITERIA Peer-reviewed articles in English or Dutch reporting on associations between patient-related characteristics and the occurrence of SDM for actual treatment decisions. INFORMATION SOURCES COCHRANE Library, Embase, MEDLINE, PsycInfo, PubMed and Web of Science were systematically searched for articles published until 25 March 2019. RESULTS The search yielded 5289 hits of which 53 were retained. Multiple categories of patient characteristics were identified: (1) sociodemographic characteristics (eg, gender), (2) general health and clinical characteristics (eg, symptom severity), (3) psychological characteristics and coping with illness (eg, self-efficacy) and (4) SDM style or preference. Many characteristics showed no association or unclear relationships with SDM occurrence. For example, for female gender positive, negative and, most frequently, non-significant associations were seen. CONCLUSIONS A large variety of patient-related characteristics have been studied, but for many the association with SDM occurrence remains unclear. The results will caution often-made assumptions about associations and provide an important step to target effective interventions to foster SDM with all patients.
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Affiliation(s)
- Sascha M Keij
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Joyce E de Boer
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Anne M Stiggelbout
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Wändi Bruine de Bruin
- Schaeffer Center for Health Policy and Economics, Dornsife Department of Psychology, and Price School of Public Policy, University of Southern California, Los Angeles, California, USA
| | - Ellen Peters
- Center for Science Communication Research, School of Journalism and Communication, University of Oregon, Eugene, Oregon, USA
| | - Saïda Moaddine
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Marleen Kunneman
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota, USA
| | - Arwen H Pieterse
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
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5
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Button E, Cardona M, Huntley K, Gavin NC, LeBlanc TW, Olsen A, Smith M, Yates P. Clinicians' Understanding of Preferences and Values of People with Hematological Malignancies at the End of Life: Concurrent Surveys. J Palliat Med 2022; 25:1386-1397. [PMID: 35443803 DOI: 10.1089/jpm.2021.0490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background: People with hematological malignancies can deteriorate rapidly to a terminal event and have variable levels of engagement when transitioning to palliative and end-of-life care. Objectives: To describe end-of-life care values and preferences of people with hematological malignancies and explore whether these align with hematology clinicians' perceptions. Design: Two matched anonymous quantitative cross-sectional surveys explored: (1) patients' values and preferences around manner and timing of discussions regarding life expectancy and prognosis, involvement in decision making, and concurrent integration of palliative care with active treatment; and (2) clinicians' perceptions of their patients' values and preferences in relation to prognostic information. Settings/Participants: Concurrent online national surveys of people with hematological malignancies known to the Leukemia Foundation of Australia, and clinicians in Australia with membership to the Hematology Society of Australia and New Zealand. Results: Five hundred nine (38% response rate) patients (median age 64 [min 20, max 89, interquartile range 56-70]) and 272 clinicians (21% response rate) responded to the survey. If their health was deteriorating, most patients wanted honest prognostic and life expectancy information (87%); welcomed involvement in decision making (94%); felt they would be comfortable talking to the treating team about the possibility of death (86%); and would be comfortable seeing someone from a specialist palliative care team (74%). Clinicians generally underestimated most of these responses. Conclusion: Although our findings indicate that most people believe they would be comfortable discussing prognosis, life expectancy, and wishes at the end of life, clinicians were largely unaware of their preferences. This highlights the need to embed values clarification in routine care for each patient and family.
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Affiliation(s)
- Elise Button
- Cancer and Palliative Outcomes Center, Center for Healthcare Transformation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Magnolia Cardona
- Institute for Evidence-Based Healthcare, Bond University, Robina, Queensland, Australia
| | - Kathryn Huntley
- Leukemia Foundation of Australia, Windsor, Queensland, Australia
| | - Nicole C Gavin
- Cancer and Palliative Outcomes Center, Center for Healthcare Transformation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Thomas W LeBlanc
- Division of Hematological Malignancies and Cellular Therapy, Duke University School of Medicine, Durham, North Carolina, USA
| | - Avalon Olsen
- Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Michael Smith
- Cancer and Palliative Outcomes Center, Center for Healthcare Transformation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Patsy Yates
- Cancer and Palliative Outcomes Center, Center for Healthcare Transformation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
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6
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Rood JAJ, Lissenberg-Witte BI, Eeltink C, Stam F, van Zuuren FJ, Zweegman S, Verdonck- de Leeuw IM. The need for information among patients with hematological malignancies: Psychometric analyses of the 62-item Hematology Information Needs Questionnaire (HINQ-62). PLoS One 2018; 13:e0201699. [PMID: 30092035 PMCID: PMC6084926 DOI: 10.1371/journal.pone.0201699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 07/22/2018] [Indexed: 11/18/2022] Open
Abstract
The purpose of this study was to investigate the psychometric characteristics (content validity, internal consistency, and subscale structure) of the Hematology Information Needs Questionnaire-62 (HINQ-62), a patient reported outcome measure (PROM) for assessing the need for information among patients with hematological malignancies (HM-patients). Baseline data were used from a prospective study on the need for information which 336 newly diagnosed HM-patients had completed. In phase 1 (design phase), data from the first 135 patients were used and in phase 2 (validation phase), data from the remaining 201 HM patients were used. Content validity was analyzed by examining irrelevance of items. Items were considered irrelevant if more than 10% of the patients scored totally disagree on that item. The subscale structure of the HINQ-62 was investigated with Factor analysis (FA) (exploratory FA in phase 1 and confirmatory FA in phase 2). Cronbach's α was computed for the different subscales and >.70 was considered as good internal consistency. None of the 62 HINQ-items were irrelevant. Exploratory FA identified five subscales: "Disease, symptoms, treatment and side-effects", "Etiology, sleep and physical changes", "Self-care", "Medical tests and prognosis", and "Psychosocial". Root Mean Square Error of Approximation (RMSEA) among patients was 0.037 in phase 1 and 0.045 in phase 2. The comparative fit index (CFI)/Tucker-Lewis index -non-normed fit index among patients was 0.984/0.983 and 0.948/0.946, in phase 1 and 2 respectively. The internal consistency of the subscales was good, with Cronbach's α 0.82-0.99. The HINQ is a valid PROM for assessing the need for information among Dutch HM-patients at diagnosis.
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Affiliation(s)
- Janneke A. J. Rood
- Department of Hematology, VU University Medical Center, Amsterdam, the Netherlands
- Department of Internal medicine, Northwest Clinics, Alkmaar, the Netherlands
- * E-mail:
| | | | - Corien Eeltink
- Department of Hematology, VU University Medical Center, Amsterdam, the Netherlands
| | - Frank Stam
- Department of Internal medicine, Northwest Clinics, Alkmaar, the Netherlands
| | | | - Sonja Zweegman
- Department of Hematology, VU University Medical Center, Amsterdam, the Netherlands
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7
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Rood J, Nauta I, Witte B, Stam F, van Zuuren F, Manenschijn A, Huijgens P, Verdonck-de Leeuw I, Zweegman S. Shared decision-making and providing information among newly diagnosed patients with hematological malignancies and their informal caregivers: Not “one-size-fits-all”. Psychooncology 2017; 26:2040-2047. [DOI: 10.1002/pon.4414] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 03/01/2017] [Accepted: 03/02/2017] [Indexed: 12/18/2022]
Affiliation(s)
- J.A.J. Rood
- Department of Hematology; VU University Medical Center; Amsterdam the Netherlands
- Department of Internal medicine; Northwest Clinics; Alkmaar the Netherlands
| | - I.H. Nauta
- Department of Hematology; VU University Medical Center; Amsterdam the Netherlands
| | - B.I. Witte
- Department of Epidemiology and Biostatistics; VU University Medical Center; Amsterdam the Netherlands
| | - F. Stam
- Department of Internal medicine; Northwest Clinics; Alkmaar the Netherlands
| | - F.J. van Zuuren
- Department of Clinical Psychology; University of Amsterdam; Amsterdam the Netherlands
| | - A. Manenschijn
- Department of Internal Medicine; Isala; Zwolle the Netherlands
| | - P.C. Huijgens
- Department of Hematology; VU University Medical Center; Amsterdam the Netherlands
| | - I.M. Verdonck-de Leeuw
- Department of Clinical Psychology; VU University Medical Center; Amsterdam the Netherlands
| | - S. Zweegman
- Department of Hematology; VU University Medical Center; Amsterdam the Netherlands
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8
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Clayman ML, Bylund CL, Chewning B, Makoul G. The Impact of Patient Participation in Health Decisions Within Medical Encounters. Med Decis Making 2015; 36:427-52. [DOI: 10.1177/0272989x15613530] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 09/18/2015] [Indexed: 02/01/2023]
Abstract
Background: Although there are compelling moral arguments for patient participation in medical decisions, the link to health outcomes has not been systematically explored. Objective: Assess the extent to which patient participation in decision making within medical encounters is associated with measured patient outcomes. Methods: We conducted a primary search in PubMed—excluding non-English and animal studies—for articles on decision making in the context of the physician–patient relationship published through the end of February 2015, using the MeSH headings (Physician-Patient Relations [MeSH] OR Patient Participation [MeSH]) and the terms (decision OR decisions OR option OR options OR choice OR choices OR alternative OR alternatives) in the title or abstract. We also conducted a secondary search of references in all articles that met the inclusion criteria. Results: A thorough search process yielded 116 articles for final analysis. There was wide variation in study design, as well as measurement of patient participation and outcomes, among the studies. Eleven of the 116 studies were randomized controlled trials (RCTs). Interventions increased patient involvement in 10 (91%) of the 11 RCTs. At least one positive outcome was detected in 5 (50%) of the 10 RCTs reporting increased participation; the ratio of positive results among all outcome variables measured in these studies was much smaller. Although proportions differed, similar patterns were found across the 105 nonrandomized studies. Conclusions: Very few RCTs in the field have measures of participation in decision making and at least one health outcome. Moreover, extant studies exhibit little consistency in measurement of these variables, and results are mixed. There is a great need for well-designed, reproducible research on clinically relevant outcomes of patient participation in medical decisions.
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Affiliation(s)
- Marla L. Clayman
- American Institutes for Research (MLC)
- Hamad Medical Corporation/Weill Cornell Medical College–Qatar (CB)
- School of Pharmacy, University of Wisconsin–Madison, WI, USA (BC)
- Connecticut Institute for Primary Care Innovation (GM)
- Department of Medicine, University of Connecticut School of Medicine, Hartford, CT, USA (GM)
| | - Carma L. Bylund
- American Institutes for Research (MLC)
- Hamad Medical Corporation/Weill Cornell Medical College–Qatar (CB)
- School of Pharmacy, University of Wisconsin–Madison, WI, USA (BC)
- Connecticut Institute for Primary Care Innovation (GM)
- Department of Medicine, University of Connecticut School of Medicine, Hartford, CT, USA (GM)
| | - Betty Chewning
- American Institutes for Research (MLC)
- Hamad Medical Corporation/Weill Cornell Medical College–Qatar (CB)
- School of Pharmacy, University of Wisconsin–Madison, WI, USA (BC)
- Connecticut Institute for Primary Care Innovation (GM)
- Department of Medicine, University of Connecticut School of Medicine, Hartford, CT, USA (GM)
| | - Gregory Makoul
- American Institutes for Research (MLC)
- Hamad Medical Corporation/Weill Cornell Medical College–Qatar (CB)
- School of Pharmacy, University of Wisconsin–Madison, WI, USA (BC)
- Connecticut Institute for Primary Care Innovation (GM)
- Department of Medicine, University of Connecticut School of Medicine, Hartford, CT, USA (GM)
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9
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Kane HL, Halpern MT, Squiers LB, Treiman KA, McCormack LA. Implementing and evaluating shared decision making in oncology practice. CA Cancer J Clin 2014; 64:377-88. [PMID: 25200391 DOI: 10.3322/caac.21245] [Citation(s) in RCA: 177] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 07/28/2014] [Accepted: 07/28/2014] [Indexed: 11/18/2022] Open
Abstract
Engaging individuals with cancer in decision making about their treatments has received increased attention; shared decision making (SDM) has become a hallmark of patient-centered care. Although physicians indicate substantial interest in SDM, implementing SDM in cancer care is often complex; high levels of uncertainty may exist, and health care providers must help patients understand the potential risks versus benefits of different treatment options. However, patients who are more engaged in their health care decision making are more likely to experience confidence in and satisfaction with treatment decisions and increased trust in their providers. To implement SDM in oncology practice, physicians and other health care providers need to understand the components of SDM and the approaches to supporting and facilitating this process as part of cancer care. This review summarizes recent information regarding patient and physician factors that influence SDM for cancer care, outcomes resulting from successful SDM, and strategies for implementing SDM in oncology practice. We present a conceptual model illustrating the components of SDM in cancer care and provide recommendations for facilitating SDM in oncology practice.
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Affiliation(s)
- Heather L Kane
- Health Services Analyst, Primary Prevention Research and Evaluation Program, RTI International, Research Triangle Park, North Carolina
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10
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Rood JAJ, van Zuuren FJ, Stam F, van der Ploeg T, Eeltink C, Verdonck-de Leeuw IM, Huijgens PC. Perceived need for information among patients with a haematological malignancy: associations with information satisfaction and treatment decision-making preferences. Hematol Oncol 2014; 33:85-98. [PMID: 24811073 DOI: 10.1002/hon.2138] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 01/30/2014] [Indexed: 11/12/2022]
Abstract
For patients with haematological malignancies, information on disease, prognosis, treatment and impact on quality of life is of the utmost importance. To gain insight into the perceived need for information in relation to sociodemographic and clinical parameters, comorbidity, quality of life (QoL) and information satisfaction, we compiled a questionnaire based on existing validated questionnaires. A total of 458 patients diagnosed with a haematological malignancy participated. The perceived need for information was moderate to high (40-70%). Multivariate regression analyses showed that a higher need for information was related to younger age, worse QoL, being member of a patient society and moderate comorbidity. The need for disease and treatment-related information was higher than the need for psychosocial information. A higher need for disease and treatment-related information was associated to being diagnosed with multiple myeloma. A higher need for psychosocial information was related to a lower educational level. The information provision could be improved according to 41% of the patients. Higher satisfaction with provided information was associated with better QoL. Most patients (62%) reported that they wanted to be fully informed about their illness and actively involved in treatment decision-making. The results contribute to improving patient-tailored information provision and shared decision-making in clinical practice.
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Affiliation(s)
- Janneke A J Rood
- Department of Haematology, VU University Medical Center, Amsterdam, The Netherlands.,Department of Internal Medicine, Medical Center Alkmaar, Alkmaar, The Netherlands
| | | | - Frank Stam
- Department of Internal Medicine, Medical Center Alkmaar, Alkmaar, The Netherlands
| | | | - Corien Eeltink
- Department of Haematology, VU University Medical Center, Amsterdam, The Netherlands
| | | | - Peter C Huijgens
- Department of Haematology, VU University Medical Center, Amsterdam, The Netherlands
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11
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Nissim R, Zimmermann C, Minden M, Rydall A, Yuen D, Mischitelle A, Gagliese L, Schimmer A, Rodin G. Abducted by the illness: a qualitative study of traumatic stress in individuals with acute leukemia. Leuk Res 2013; 37:496-502. [PMID: 23352641 PMCID: PMC3808345 DOI: 10.1016/j.leukres.2012.12.007] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2012] [Revised: 12/01/2012] [Accepted: 12/11/2012] [Indexed: 11/26/2022]
Abstract
Symptoms of traumatic stress are common in acute leukemia. The goal of the present qualitative study was to understand this traumatic stress, as perceived by patients. Participants were 43 patients with acute leukemia in Toronto, Canada. Participants were asked in serial interviews about their experience of diagnosis and treatment. A total of 65 interviews were analyzed utilizing the grounded theory method. Our findings provide insight into the traumatic experience of the diagnosis and treatment, as well as the initial psychological response to this trauma. Patients coped by surrendering control to the medical team, in whom they felt great trust. Patients also expressed a strong preference for limited information, with a preference to avoid discussions about overall prognosis. These results may inform interventions to relieve traumatic stress in this high risk population.
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Affiliation(s)
- Rinat Nissim
- Department of Psychosocial Oncology and Palliative Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
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12
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Current World Literature. Curr Opin Oncol 2012; 24:454-60. [DOI: 10.1097/cco.0b013e328355876c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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