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Wang X, Watson BM. Exploring Foreign Domestic Workers' Perceived Contextual Factors That Influence Their Participation in Medical Consultations: An Ecological Lens. HEALTH COMMUNICATION 2024; 39:161-172. [PMID: 36581461 DOI: 10.1080/10410236.2022.2162233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Foreign domestic workers have reported various health problems after moving to Hong Kong, which suggests the need for them to seek medical attention. Yet, much uncertainty exists about their perception of healthcare experiences as patients, particularly how they perceive their communication with ethnic-discordant healthcare providers. Drawing on foreign domestic workers' perspectives, we extracted non-interpersonal factors from Street's ecological model and its extension proposed by Head and Bute (2018) and examined how foreign domestic workers perceived these contextual factors affected their communication with healthcare providers. Thematic analysis was conducted on thirty Filipina and Indonesian domestic workers' narratives. Our findings confirmed that the context of digital media (characterized by Internet use and the adoption of a telemedicine approach) and the context of social ties (characterized by employers' involvement and everyday communication with friends and peers) were both potential contextual factors that domestic workers reported accounted for their participation in medical encounters. Theoretical and practical implications are discussed. Future research building on these findings is proposed.
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Affiliation(s)
- Xixi Wang
- Department of English and Communication, The International Research Centre for the Advancement of Health Communication, The Hong Kong Polytechnic University
| | - Bernadette Maria Watson
- Department of English and Communication, The International Research Centre for the Advancement of Health Communication, The Hong Kong Polytechnic University
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2
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Tielemans LML, van Heugten KD, Hamaker ME, van Walree IC. Preferred and actual involvement of caregivers in oncologic treatment decision-making: A systematic review. J Geriatr Oncol 2023; 14:101525. [PMID: 37198027 DOI: 10.1016/j.jgo.2023.101525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/04/2023] [Accepted: 05/09/2023] [Indexed: 05/19/2023]
Abstract
INTRODUCTION Treatment decision-making in cancer is complex and many patients bring their caregiver to appointments to help them make those decisions. Multiple studies show the importance of involving caregivers in the treatment decision-making process. We aimed to explore the preferred and actual involvement of caregivers in the decision-making process of patients with cancer and to see if there are age or cultural background related differences in caregiver involvement. MATERIALS AND METHODS A systematic review of Pubmed and Embase was performed on January 2, 2022. Studies containing numerical data regarding caregiver involvement were included, as were studies describing the agreement between patients and caregivers regarding treatment decisions. Studies assessing solely patients aged younger than 18 years old or terminally ill patients, and studies without extractable data were excluded. Risk of bias was assessed by two independent reviewers using an adapted version of the Newcastle-Ottawa scale. Results were analysed in two separate age groups, one <62 years and one ≥62 years. RESULTS Twenty-two studies with a total of 11,986 patients and 6,260 caregivers were included in this review. A median of 75% of patients preferred caregivers to be involved in decision-making and a median of 85% of caregivers preferred to be involved. With regards to age groups, the preferred involvement of caregivers was more frequent in the younger study populations. With regards to geographical differences, studies performed in Western countries showed a lower preference for caregiver's involvement compared to studies from Asian countries. A median of 72% of the patients reported the caregiver was actually involved in the treatment decision-making and a median of 78% of the caregivers reported they were actually involved. The most important role of caregivers was to listen and provide emotional support. DISCUSSION Patients and caregivers both want caregivers to be involved in the treatment decision-making process and most caregivers are actually involved. An ongoing dialogue between clinicians, patients and caregivers about decision-making is important to meet the individual patient's and caregiver's needs when involved in the decision-making process. Important limitations were a lack of studies in older patients and significant differences in outcome measures among studies.
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Affiliation(s)
- Laura M L Tielemans
- Department of Geriatric Medicine, Elisabeth-Twee Steden Ziekenhuis, Tilburg, the Netherlands.
| | - Kirsten D van Heugten
- Department of Geriatric Medicine, Elisabeth-Twee Steden Ziekenhuis, Tilburg, the Netherlands
| | - Marije E Hamaker
- Department of Geriatric Medicine, Diakonessenhuis Utrecht, the Netherlands
| | - Inez C van Walree
- Department of Geriatric Medicine, University Medical Centrum Utrecht, Utrecht, the Netherlands
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Murong M, Giannopoulos E, Pirrie L, Giuliani ME, Fazelzad R, Bender J, Jones J, Papadakos J. The Experience of Informal Newcomer Cancer Caregivers with Limited Language Proficiency: A Scoping Review. J Immigr Minor Health 2023; 25:436-448. [PMID: 36538206 DOI: 10.1007/s10903-022-01442-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
This scoping review explored what is known about the experiences of informal cancer caregivers (CGs) who are newcomers with limited language proficiency. A literature search was performed in seven databases and the search yielded 11,289 articles. After duplicate removal and title and abstract screening, 216 articles underwent full text review and 57 articles and were synthesized. Most studies (n = 41, 72%) were qualitative and were published in North America (n = 35, 61%). Most CG participants were female (69%) and only 19 studies explicitly identified the CG country of origin. Of those that did, 26% originated from Asia, with most migrating from East Asia. Significant challenges were experienced by newcomer CGs and chief among these were related to communication challenges with HCPs that were exacerbated by a lack of availability of medical interpreters and the complexity of oncology health information. Efforts are needed to better integrate newcomer CGs into cancer care.
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Affiliation(s)
- Mijia Murong
- Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Eleni Giannopoulos
- Cancer Health Literacy Research Centre, Cancer Education Program, Princess Margaret Cancer Centre, 585 University Avenue, ELLICSR PMB B-130, Toronto, ON, M5G 2N2, Canada
| | - Lorraine Pirrie
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Meredith Elana Giuliani
- Faculty of Medicine, University of Toronto, Toronto, Canada.,Cancer Health Literacy Research Centre, Cancer Education Program, Princess Margaret Cancer Centre, 585 University Avenue, ELLICSR PMB B-130, Toronto, ON, M5G 2N2, Canada.,The Institute for Education Research, University Health Network, Toronto, Canada.,Department of Radiation of Oncology, Princess Margaret Cancer Centre, Toronto, Canada
| | - Rouhi Fazelzad
- Library and Information Services, Princess Margaret Cancer Centre, Toronto, Canada
| | - Jacqueline Bender
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Canada
| | - Jennifer Jones
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Canada
| | - Janet Papadakos
- Cancer Health Literacy Research Centre, Cancer Education Program, Princess Margaret Cancer Centre, 585 University Avenue, ELLICSR PMB B-130, Toronto, ON, M5G 2N2, Canada. .,Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada. .,The Institute for Education Research, University Health Network, Toronto, Canada.
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Maillard J, Beckmann TS, Tramèr MR, Elia N. Reviewing next of kin regrets in surgical decision-making: cross-sectional analysis of systematically searched literature. J Patient Rep Outcomes 2023; 7:5. [PMID: 36695927 PMCID: PMC9877257 DOI: 10.1186/s41687-023-00539-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 01/03/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Decision-making concerning relatives undergoing surgery is challenging. It remains unclear to what extent implicated next of kin eventually regret their decisions and how this regret is assessed. Our aim was to systematically review the literature on decisional regret of next of kin and to describe the assessment tools used and the surgical populations studied. METHODS We included interventional or observational, quantitative or qualitative studies reporting the measurement of decisional regret of next of kin concerning relatives undergoing surgery. We searched a variety of databases without restriction on publication year. We assessed the quality of reporting of quantitative studies using the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and of qualitative studies using the Critical Appraisal Skills Program Checklist. RESULTS Thirteen cross-sectional, five prospective cohorts and five qualitative studies matched our inclusion criteria. In 18 studies (78%), patients were children, in five (22%), young or middle-aged adults. No study included elderly or frail patients. Thirteen studies (57%) used the original Decision Regret Scale which was validated for patients, but not for next of kin. Only 3 of the 18 (17%) quantitative studies and only one of the 4 (25%) qualitative studies were rated as "good" in the quality assessment. CONCLUSION None of the retrieved studies used validated tools to assess the decisional regret of next of kin and none of them examined this issue in elderly or frail surgical patients.
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Affiliation(s)
- Julien Maillard
- grid.150338.c0000 0001 0721 9812Division of Anesthesiology, Department of Anesthesiology, Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
| | - Tal S. Beckmann
- grid.150338.c0000 0001 0721 9812Division of Anesthesiology, Department of Anesthesiology, Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
| | - Martin R. Tramèr
- grid.150338.c0000 0001 0721 9812Division of Anesthesiology, Department of Anesthesiology, Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
| | - Nadia Elia
- grid.150338.c0000 0001 0721 9812Division of Anesthesiology, Department of Anesthesiology, Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
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Veenstra CM, Ellis KR, Abrahamse P, Ward KC, Morris AM, Hawley ST. A dyadic survey study of partner engagement in and patient receipt of guideline-recommended colorectal cancer surveillance. BMC Cancer 2022; 22:1060. [PMID: 36229796 PMCID: PMC9559022 DOI: 10.1186/s12885-022-10131-3] [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] [Received: 05/24/2022] [Accepted: 09/21/2022] [Indexed: 11/25/2022] Open
Abstract
Background We investigated whether partner (spouse or intimate partner) engagement in colorectal cancer (CRC) surveillance is associated with patient receipt of surveillance. Methods From 2019 to 2020 we surveyed Stage III CRC survivors diagnosed 2014–2018 at an academic cancer center, a community oncology practice and the Georgia SEER registry, and their partners. Partner engagement was measured across 3 domains: Informed about; Involved in; and Aware of patient preferences around surveillance. We evaluated bivariate associations between domains of partner engagement and independent partner variables. Analysis of variance and multivariable logistic regression were used to compare domains of engagement with patient-reported receipt of surveillance. Results 501 patients responded (51% response rate); 428 had partners. 311 partners responded (73% response rate). Partners were engaged across all domains. Engagement varied by sociodemographics. Greater partner involvement was associated with decreased odds of receipt of composite surveillance (OR 0.67, 95% CI 0.48–0.93) and trended towards significance for decreased odds of receipt of endoscopy (OR 0.60, 95% CI 0.34–1.03) and CEA (OR 0.75, 95% CI 0.55–1.04). Greater partner awareness was associated with increased odds of patients’ receipt of endoscopy (OR 2.18, 95% CI 1.15–4.12) and trended towards significance for increased odds of receipt of composite surveillance (OR 1.30, 95% CI 0.91–2.04). Conclusion Partners are engaged (informed, involved, and aware) in CRC surveillance. Future research to develop dyadic interventions that capitalize on the positive aspects of partner engagement may help partners effectively engage in surveillance to improve patient care. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-10131-3.
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Affiliation(s)
- Christine M Veenstra
- University of Michigan, 300 North Ingalls, NIB, Room 3A22, 48109, Ann Arbor, MI, USA.
| | - Katrina R Ellis
- University of Michigan, 300 North Ingalls, NIB, Room 3A22, 48109, Ann Arbor, MI, USA
| | - Paul Abrahamse
- University of Michigan, 300 North Ingalls, NIB, Room 3A22, 48109, Ann Arbor, MI, USA
| | | | | | - Sarah T Hawley
- University of Michigan, 300 North Ingalls, NIB, Room 3A22, 48109, Ann Arbor, MI, USA
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Deem MJ, Stokes F. Culture and Consent in Clinical Care: A Critical Review of Nursing and Nursing Ethics Literature. ANNUAL REVIEW OF NURSING RESEARCH 2019; 37:223-259. [PMID: 30692159 DOI: 10.1891/0739-6686.37.1.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Veenstra CM, Wallner LP, Abrahamse P, Janz NK, Katz SJ, Hawley ST. Understanding the engagement of key decision support persons in patient decision making around breast cancer treatment. Cancer 2019; 125:1709-1716. [PMID: 30633326 PMCID: PMC6486440 DOI: 10.1002/cncr.31956] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 11/20/2018] [Accepted: 11/29/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Patients with breast cancer involve multiple decision support persons (DSPs) in treatment decision making, yet little is known about DSP engagement in decision making and its association with patient appraisal of the decision process. METHODS Patients newly diagnosed with breast cancer reported to Georgia and Los Angeles Surveillance, Epidemiology, and End Results registries in 2014-2015 were surveyed 7 months after their diagnosis. The individual most involved in each respondent's decision making (the key DSP) was surveyed. DSP engagement was measured across 3 domains: 1) informed about decisions, 2) involved in decisions, and 3) aware of patient preferences. Patient decision appraisal included subjective decision quality (SDQ) and deliberation. This study evaluated bivariate associations with chi-square tests between domains of DSP engagement and independent DSP variables. Analysis of variance and multivariable logistic regression were used to compare domains of DSP engagement with patient decision appraisal. RESULTS In all, 2502 patients (68% response rate) and 1203 eligible DSPs (70% response rate) responded. Most DSPs were husbands/partners or daughters, were white, and were college graduates. Husbands/partners were more likely to be more informed, involved, and aware (all P values < .01). English- and Spanish-speaking Latinos had a higher extent of (P = .02) but lower satisfaction with involvement (P < .01). A highly informed DSP was associated with higher odds of patient-reported SDQ (odds ratio, 1.46; 95% confidence interval, 1.03-2.08; P = .03). A highly aware DSP was associated with higher odds of patient-reported deliberation (odds ratio, 1.83; 95% confidence interval, 1.36-2.47; P < .01). CONCLUSIONS In this population-based study, informal DSPs were engaged with and positively contributed to patients' treatment decision making. To improve decision quality, future interventions should incorporate DSPs.
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Affiliation(s)
- Christine M. Veenstra
- Department of Internal Medicine, Division of Hematology/Oncology, University of Michigan, Ann Arbor, MI
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan
| | - Lauren P. Wallner
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI
- Department of Epidemiology, University of Michigan, Ann Arbor, MI
| | - Paul Abrahamse
- Department of Biostatistics, University of Michigan, Ann Arbor, MI
| | - Nancy K. Janz
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI
| | - Steven J. Katz
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI
- Department of Health Management and Policy, University of Michigan, Ann Arbor, MI
| | - Sarah T. Hawley
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI
- Department of Health Management and Policy, University of Michigan, Ann Arbor, MI
- Ann Arbor Veterans Affairs Center for Clinical Management Research, Ann Arbor, Michigan
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8
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The influence of partner involvement in the decision-making process on body image and decision regret among women receiving breast reconstruction. Support Care Cancer 2018; 27:1721-1728. [PMID: 30132239 DOI: 10.1007/s00520-018-4416-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 08/08/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE This study examines the influence of partner involvement in decision-making for breast reconstruction (BR) on women's body image and post-BR decision regret. METHODS A cross-sectional and correlational approach was used in a convenience sample of 105 women in Taiwan who had breast cancer (BC) whose partners were involved in decision-making for BR. A structured questionnaire including the Involvement in the Breast Reconstruction Decision-Making Process Scale, the Body Image Scale, and the Decision Regret Scale was administered. Pearson's r and path analysis were used to examine the relationships among the dyadic BR decision-making process, women's body image, and decision regret. RESULTS The greater the amount of medical information women had, the better their body image and the less decision regret they experienced. Moreover, partner involvement was not related to women's body image, though it was inversely related to women's decision regret. The final path model showed that the amount of medical information women obtained was directly related to body image and decision regret, while body image also directly influenced decision regret. Overall, the amount of medical information women obtained and their body image explained 45% of the variance in decision regret. CONCLUSIONS Medical teams should provide female BC patients with complete medical information, and through partner involvement, women can be supported to make an appropriate decision regarding BR to achieve optimal levels of body image and lower levels of decision regret.
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Veenstra CM, Wallner LP, Jagsi R, Abrahamse P, Griggs JJ, Bradley CJ, Hawley ST. Long-Term Economic and Employment Outcomes Among Partners of Women With Early-Stage Breast Cancer. J Oncol Pract 2017; 13:e916-e926. [PMID: 28880714 PMCID: PMC5684882 DOI: 10.1200/jop.2017.023606] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Work loss is one of many personal costs for patients with cancer and their families. Many women with breast cancer face long-term job loss that stems from their diagnoses. However, little is known about the economic and employment outcomes of partners of women with breast cancer. METHODS Women with nonmetastatic breast cancer identified by the Detroit and Los Angeles SEER registries between June 2005 and February 2007 were surveyed at both 9 months and 4 years after diagnosis. Partners were surveyed 4 years after patients' diagnoses. Nonretired partners were asked about employment and financial consequences that stemmed from the patients' breast cancer diagnoses and treatments. RESULTS A total of 517 (67%) of 774 eligible partners completed the survey; 32% reported worsened financial status attributed to patients' breast cancers. Two hundred forty nonretired partners worked during the year after the patients' diagnoses; 90% were still working 4 years postdiagnosis. A total of 32% of partners decreased their work hours as a result of patients' breast cancer diagnoses and treatments; 64% of partners reported that, as a result of patients' breast cancer diagnoses and treatments, it was very/extremely important to keep working to keep health insurance. Overall, 51% of partners reported that it was very/extremely important to avoid changing jobs, because they were worried about loss of health insurance. CONCLUSION Nearly one third of partners reported that their financial status was worse because of the patient's breast cancer, although most remained working 4 years after a diagnosis. Partners may continue to work longer than desired to compensate for a loss of financial resources in the family.
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Affiliation(s)
- Christine M. Veenstra
- University of Michigan; Ann Arbor VA Healthcare System, Ann Arbor, MI; and University of Colorado Cancer Center, Denver, CO
| | - Lauren P. Wallner
- University of Michigan; Ann Arbor VA Healthcare System, Ann Arbor, MI; and University of Colorado Cancer Center, Denver, CO
| | - Reshma Jagsi
- University of Michigan; Ann Arbor VA Healthcare System, Ann Arbor, MI; and University of Colorado Cancer Center, Denver, CO
| | - Paul Abrahamse
- University of Michigan; Ann Arbor VA Healthcare System, Ann Arbor, MI; and University of Colorado Cancer Center, Denver, CO
| | - Jennifer J. Griggs
- University of Michigan; Ann Arbor VA Healthcare System, Ann Arbor, MI; and University of Colorado Cancer Center, Denver, CO
| | - Cathy J. Bradley
- University of Michigan; Ann Arbor VA Healthcare System, Ann Arbor, MI; and University of Colorado Cancer Center, Denver, CO
| | - Sarah T. Hawley
- University of Michigan; Ann Arbor VA Healthcare System, Ann Arbor, MI; and University of Colorado Cancer Center, Denver, CO
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Wallner LP, Li Y, McLeod MC, Hamilton AS, Ward KC, Veenstra CM, An LC, Janz NK, Katz SJ, Hawley ST. Decision-support networks of women newly diagnosed with breast cancer. Cancer 2017; 123:3895-3903. [PMID: 28640360 PMCID: PMC5626589 DOI: 10.1002/cncr.30848] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 05/19/2017] [Accepted: 05/24/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND Little is known about the size and characteristics of the decision-support networks of women newly diagnosed with breast cancer and whether their involvement improves breast cancer treatment decisions. METHODS A population-based sample of patients newly diagnosed with breast cancer in 2014 and 2015, as reported to the Georgia and Los Angeles Surveillance, Epidemiology, and End Results registries, were surveyed approximately 7 months after diagnosis (N = 2502; response rate, 68%). Network size was estimated by asking women to list up to 3 of the most important decision-support persons (DSPs) who helped them with locoregional therapy decisions. Decision deliberation was measured using 4 items assessing the degree to which patients thought through the decision, with higher scores reflecting more deliberative breast cancer treatment decisions. The size of the network (range, 0-3 or more) was compared across patient-level characteristics, and adjusted mean deliberation scores were estimated across levels of network size using multivariable linear regression. RESULTS Of the 2502 women included in this analysis, 51% reported having 3 or more DSPs, 20% reported 2, 18% reported 1, and 11% reported not having any DSPs. Married/partnered women, those younger than 45 years, and black women all were more likely to report larger network sizes (all P < .001). Larger support networks were associated with more deliberative surgical treatment decisions (P < .001). CONCLUSIONS Most women engaged multiple DSPs in their treatment decision making, and involving more DSPs was associated with more deliberative treatment decisions. Future initiatives to improve treatment decision making among women with breast cancer should acknowledge and engage informal DSPs. Cancer 2017;123:3895-903. © 2017 American Cancer Society.
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Affiliation(s)
- Lauren P. Wallner
- University of Michigan, Department of Internal Medicine
- University of Michigan, Department of Epidemiology
| | - Yun Li
- University of Michigan, Department of Biostatistics
| | | | - Ann S. Hamilton
- University of Southern California Keck School of Medicine, Department of Preventive Medicine
| | | | - Christine M. Veenstra
- University of Michigan, Department of Internal Medicine, Division of Hematology and Oncology
| | | | - Nancy K. Janz
- University of Michigan, Department of Health Behavior and Health Education
| | - Steven J. Katz
- University of Michigan, Department of Internal Medicine
- University of Michigan, Department of Health Management and Policy
| | - Sarah T. Hawley
- University of Michigan, Department of Internal Medicine
- University of Michigan, Department of Health Behavior and Health Education
- University of Michigan, Department of Health Management and Policy
- Ann Arbor VA Center for Clinical Management Research
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Lopes VB, Lobo APA, Da Silva Junior GB, Melo AK, Lamboglia CG, Silva CABD. The experience of male spouses in the context of breast cancer: a systematic review of the literature. PSYCHOL HEALTH MED 2017; 23:89-98. [DOI: 10.1080/13548506.2017.1332374] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | | | | | - Anna Karynne Melo
- Postgraduate Program in Collective Health, University of Fortaleza (Unifor), Fortaleza, Brazil
- Postgraduate Program in Psychology, University of Fortaleza (Unifor), Fortaleza, Brazil
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Hawley ST, Morris AM. Cultural challenges to engaging patients in shared decision making. PATIENT EDUCATION AND COUNSELING 2017; 100:18-24. [PMID: 27461943 PMCID: PMC5164843 DOI: 10.1016/j.pec.2016.07.008] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 07/02/2016] [Indexed: 05/08/2023]
Abstract
OBJECTIVE Engaging patients in their health care through shared decision-making is a priority embraced by several national and international groups. Missing from these initiatives is an understanding of the challenges involved in engaging patients from diverse backgrounds in shared decision-making. In this commentary, we summarize some of the challenges and pose points for consideration regarding how to move toward more culturally appropriate shared decision-making. DISCUSSION The past decade has seen repeated calls for health policies, research projects and interventions that more actively include patients in decision making. Yet research has shown that patients from different racial/ethnic and cultural backgrounds appraise their decision making process less positively than do white, U.S.-born patients who are the current demographic majority. CONCLUSION While preliminary conceptual frameworks have been proposed for considering the role of race/ethnicity and culture in healthcare utilization, we maintain that more foundational and empirical work is necessary. We offer recommendations for how to best involve patients early in treatment and how to maximize decision making in the way most meaningful to patients. Innovative and sustained efforts are needed to educate and train providers to communicate effectively in engaging patients in informed, shared decision-making and to provide culturally competent health care.
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Affiliation(s)
- Sarah T Hawley
- Professor of Medicine and Health Management and Policy, University of Michigan & Research Investigator, Ann Arbor VA Center for Clinical Management Research, 2800 Plymouth Road, 4th Floor, Ann Arbor, MI 48109, United States.
| | - Arden M Morris
- Associate Professor of Surgery and Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, United States
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Janz NK, Li Y, Beesley LJ, Wallner LP, Hamilton AS, Morrison RA, Hawley ST. Worry about recurrence in a multi-ethnic population of breast cancer survivors and their partners. Support Care Cancer 2016; 24:4669-78. [PMID: 27378380 DOI: 10.1007/s00520-016-3314-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 06/13/2016] [Indexed: 01/05/2023]
Abstract
PURPOSE The objectives of this study are to describe racial/ethnic differences and clinical/treatment correlates of worry about recurrence and examine modifiable factors in the health care experience to reduce worry among breast cancer survivors, partners, and pairs. METHODS Women with non-metastatic breast cancer identified by the Detroit and Los Angeles SEER registries between 6/05 and 2/07 were surveyed at 9 months and 4 years. Latina and Black women were oversampled. Partners were surveyed at time 2. Worry about recurrence was regressed on sociodemographics, clinical/treatment, and modifiable factors (e.g., emotional support received by providers) among survivors, partners, and pairs. RESULTS The final sample included 510 pairs. Partners reported more worry about recurrence than survivors. Compared to Whites, Latinas(os) were more likely to report worry and Blacks were less likely to report worry (all p < 0.05). Partners of survivors who received chemotherapy reported more worry (OR = 2.47 [1.45, 4.22]). Among modifiable factors, survivors and pairs who received more emotional support from providers were less likely to report worry than those survivors and pairs who did not receive such support (OR = 0.56 [0.32, 0.97]) and (OR = 0.45 [0.23,0.85]), respectively. CONCLUSIONS Early identification of survivors and partners who are reporting considerable worry about recurrence can lead to targeted culturally sensitive interventions to avoid poorer outcomes. Interventions focused on health care providers offering information on risk and emotional support to survivors and partners is warranted.
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Affiliation(s)
- Nancy K Janz
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA.
| | - Yun Li
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Lauren J Beesley
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | | | - Ann S Hamilton
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Sarah T Hawley
- University of Michigan Medical School, Ann Arbor, MI, USA.,Ann Arbor VA Medical Center, Ann Arbor, MI, USA
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Martinez KA, Li Y, Resnicow K, Graff JJ, Hamilton AS, Hawley ST. Decision Regret following Treatment for Localized Breast Cancer: Is Regret Stable Over Time? Med Decis Making 2014; 35:446-57. [PMID: 25532824 DOI: 10.1177/0272989x14564432] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 11/21/2014] [Indexed: 12/18/2022]
Abstract
BACKGROUND While studies suggest most women have little regret regarding their breast cancer treatment decisions immediately following treatment, no studies to date have evaluated how regret may change over time. OBJECTIVE To measure the stability of posttreatment decision regret over time among women with breast cancer. METHODS Women diagnosed with breast cancer between August 2005 and May 2007 reported to the Detroit, Michigan, or Los Angeles County Surveillance, Epidemiology, and End Results (SEER) registry and completed surveys at 9 months following diagnosis (time 1) and again approximately 4 years later (time 2). A decision regret scale consisting of 5 items was summed to create 2 decision regret scores at both time 1 and time 2 (range, 0-20). Multivariable linear regression was used to examine change in regret from 9 months to 4 years. Independent variables included surgery type, receipt of reconstruction, and recurrence status at follow-up. The model controlled for demographic and clinical factors. RESULTS The analytic sample included 1536 women. Mean regret in the overall sample was 4.9 at time 1 and 5.4 at time 2 (P < 0.001). In the multivariable linear model, we found no difference in change in decision regret over time by surgery type. Reporting a new diagnosis of breast cancer at time 2 was associated with a 2.6-point increase in regret over time compared with women without an additional diagnosis (P = 0.003). Receipt of reconstruction was not associated with change in decision regret over time. CONCLUSIONS Decision regret following treatment was low and relatively stable over time for most women. Those facing an additional diagnosis of breast cancer following treatment may be at risk for elevated regret-related distress.
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Affiliation(s)
- Kathryn A Martinez
- VA Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan (KAM, STH)
| | - Yun Li
- University of Michigan School of Public Health, Department of Biostatistics, Ann Arbor, Michigan (YL)
| | - Ken Resnicow
- University of Michigan School of Public Health, Department of Health Behavior and Health Education, Ann Arbor, Michigan (KR)
| | - John J Graff
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey (JJG)
| | - Ann S Hamilton
- Keck School of Medicine, University of Southern California, Los Angeles, California (ASH)
| | - Sarah T Hawley
- VA Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan (KAM, STH),University of Michigan, Division of General Medicine, Ann Arbor, Michigan (STH)
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