Enhancing Involvement In Treatment Decision Making By Women With Breast Cancer
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Enhancing Involvement In Treatment Decision Making By Women With Breast Cancer
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Author :
language : en
Publisher:
Release Date : 2006
Enhancing Involvement In Treatment Decision Making By Women With Breast Cancer written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2006 with categories.
Women with breast cancer desire more information about their disease, in part, to be involved in making treatment decisions (TDs). Patient involvement responds to patients' desires for autonomy and addresses ethical concerns about rights to make TDs. However, several researchers have reported that patients' actual experiences in TDM did not match their preferences. The study objectives are to 1) understand the meaning of involvement in TDM from the perspectives of women with early stage breast cancer (ESBO); 2) identify stages or steps of TDM used by women and their physicians during the treatment consultation(s); and 3) identify the behaviors of women and physicians that facilitate or impede women's involvement in TDM. A qualitative approach with interviews and video-stimulated recall is being used In Phase 1 interviews with 19 women with ESBO were held to understand the concept of involvement in TDM. In Phase 2, consultations of a second group of 20 women are being digitally videotaped. Subsequently, women and their physicians (separately) view their consultation to identify any behaviors that facilitated or inhibited involvement in TDM. All interviews were taped, transcribed verbatim and analyzed Phase 1: Most women wanted high quality information soon after diagnosis but many felt isolated and uninformed until the surgical or even the medical oncology visit Most women thought they were heavily involved in a TDM process before, during and after the consultation The results of the Phase 2 pilot testing indicated that videotaping the consultation was feasible The information from this study will be useful to patients and physicians for promoting patient involvement It can be used to develop and evaluate training programs for both physicians and patients to involve patients with cancer in decisions about their care.
Factors Related To Patient Participation Congruence In Decision Making Among Women With Breast Cancer
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Author : Biwen Xu
language : en
Publisher: Open Dissertation Press
Release Date : 2017-01-27
Factors Related To Patient Participation Congruence In Decision Making Among Women With Breast Cancer written by Biwen Xu and has been published by Open Dissertation Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017-01-27 with categories.
This dissertation, "Factors Related to Patient Participation Congruence in Decision Making Among Women With Breast Cancer: a Systematic Review" by Biwen, Xu, 許璧文, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: Background Breast cancer prevalence is increasing in most countries. Not only the threat of death and impact of breast cancer treatment, but also the participation roles during treatment decision making can be substantial, leading to psychological distress and poor quality of life. Previous studies have explored patients' participation preference, the extent of participation congruence and related factors, revealing that women suffering from breast cancer may benefit from participation in treatment decision making whilst participation incongruity could be potentially detrimental for women with breast cancer. Objectives This study aimed to systematically review the literature and summarize the extent of breast cancer patients' participation preference, participation congruence, and related factors. Methods Multiple searches for key words were conducted through electronic sources, including PubMed, PsycINFO, and Medline via Ovid databases for all relevant English language literature. Studies were selected basing on specific inclusion/exclusion criteria. The STROBE checklist was applied for reporting quality assessment. Results A total of 778 studies were identified. Twelve eligible studies were included in this review. Twelve factors relating to breast cancer women's participation congruence in treatment decision making were identified as follows: age, nature of preferred role of treatment decision making, educational level, time related issues, language/ethnicity, marital status, information and recommendations of treatment, offering treatment options, physician characteristics, type of therapy or cancer program, stage of breast cancer, and surgeon volume. Conclusions Three themes (i.e. patient oriented, physician-patient interaction, and medical provision) of intervention points towards patient participation congruence were synthesized and discussed, and they were useful for improving the quality of existing breast cancer treatment decision making by addressing patient's perceived participation congruence. DOI: 10.5353/th_b5320745 Subjects: Breast - Cancer - Treatment - Decision making
Participation In Treatment Decision Making By Women With Early Stage Breast Cancer
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Author :
language : en
Publisher:
Release Date : 1997
Participation In Treatment Decision Making By Women With Early Stage Breast Cancer written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1997 with Breast categories.
Shared Decision Making
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Author : Ann Fu Chou
language : en
Publisher:
Release Date : 2002
Shared Decision Making written by Ann Fu Chou and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2002 with categories.
Breast Cancer
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Author : Anna M. Maslin
language : en
Publisher:
Release Date : 1999
Breast Cancer written by Anna M. Maslin and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1999 with Health & Fitness categories.
Of all cancers, probably breast cancer is one of the most emotive. Increasingly patients with breast cancer are participating in the surgical and/or medical decisions about their treatment. This involvement raises ethical issues about the rights of patients and their ability to give an informed consent, concerns about the process of communication between the medical staff and the patient, and also issues about the psychology of not only the woman with breast cancer, but also the doctor. This book addresses these issues relating to shared decision making and in particular those areas where a choice of treatment option involves some degree of risk/benefit analysis. It covers the ethical principles and then looks at the evidence that women who are fully informed and who have taken part in the decision making process regarding their treatment, and who have a positive attitude towards their illness, tend to do better in the long run. Appropriate experts have contributed sections on the different treatment options to provide a brief overview of the treatments available and highlight the issues that should be considered by the woman and the doctor in the decision making process. There is also a section on the patients perspective and vignettes throughout to illustrate the importance of communication.
Cancer Communication Uncertainty And Patient Satisfaction
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Author : Tara Traeder
language : en
Publisher:
Release Date : 2015
Cancer Communication Uncertainty And Patient Satisfaction written by Tara Traeder and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2015 with categories.
A breast cancer diagnosis coupled with the necessity that treatment decisions be made soon after diagnosis often results in a great deal of stress and fear for patients. A key element of effectively engaging cancer patients in their diagnosis, treatment, and survivorship is appropriate and effective communication. The role of the patient navigator has emerged in breast cancer care over the last decade to help integrate information and care processes. A patient navigator is a cancer-care provider who offers support and guidance to breast cancer patients. Having a patient navigator on a cancer-care team may enhance the patient-centered care and significantly improve the effectiveness of communication during cancer treatment. Breast cancer treatment is a preference-sensitive decision because in most cases of breast cancer treatment, there is no clear best clinical choice. Instead, patients apply their personal values and beliefs to select the option they feel is best. Throughout the process of cancer screening, diagnosis, treatment and survivorship, there are many points of uncertainty. The purpose of the research reported herein was to assess the communicative influence of patient navigators on breast cancer patients' decision-making process. Specifically, I sought to determine if women who have access to a patient navigator during breast cancer treatment decision-making better manage uncertainty and experience greater patient satisfaction with the overall care experience than women who do not have access to a patient navigator. Participants in an online survey included 124 female breast cancer survivors who had finished active breast cancer treatment within three years of participating. The survey was distributed via convenience snowball sampling. Measures of interest were patient-centered communication, decisional conflict, and patient satisfaction. Qualitative interviews were conducted with 11 women who were selected via a purposeful random sampling procedure from the sample of online survey participants in the interests of better understanding the nuanced experience of breast cancer patients' treatment decision-making experience. Factor analysis revealed clusters appropriate to the dimensions of patient-centered communication, decisional conflict, and patient satisfaction. Independent samples t-tests and multiple regression analyses were used to test hypotheses. Several significant results surfaced in comparisons of participants who had a patient navigator on their cancer-care teams and others who did not. Participants who had a patient navigator as part of their cancer-care teams scored significantly higher on patient engagement, individual confirmation, decisional support, and patient satisfaction with the care experience than ones who did not. Patient-centered communication was a predictor of both decisional conflict and patient satisfaction, but only interpersonal sincerity and patient engagement revealed significant relationships when controlling for the other predictor variables. For the qualitative analysis, 19 categories emerged from semi-structured interviews with breast cancer survivors who had finished active treatment during the last three years. Categories included: (a) communication of the diagnosis, (b) uncertainty following diagnosis, (c) communication about treatment options, (d) information-processing of treatment options, (e) treatment decision-making process, (f) decision time pressure, (g) uncertainty during decision-making, (h) information-seeking, (i) decision-makers, (j) decisional support, (k) satisfaction with treatment decisions, (l) emotional support during decision-making, (m) cancer-care team composition and roles, (n) communication with patient navigators, (o) advanced provision of information/avoiding surprises, (p) communication between cancer-care team members, (q) fertility decisions, (r) survivor support, and (s) uncertainty of finishing treatment. Categories were further sub-divided for easier interpretation of quantitative data using qualitative feedback, which is described in detail. The results of this quasi-experimental examination of communication during cancer care and the influence on decisional conflict and patient satisfaction offer insights related to theoretical significance, the importance and the impact of patient navigators as members of a cancer-care team, and the practical implications for breast cancer-related communication. There appears to be a critical influence of nonverbal aspects of communication, namely proxemics, in the structural layout of cancer centers relating to a patient's ability to manage uncertainty. Implications for breast cancer communication involve a need to create consistency in patient navigation research and practice, improve communication about the timeframe necessary for breast cancer decision-making, and ensure patients receive sufficient social support throughout treatment decision-making.
Women And Breast Cancer
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Author : Lori D. Belle-Isle
language : en
Publisher:
Release Date : 1995
Women And Breast Cancer written by Lori D. Belle-Isle and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1995 with Breast categories.
Studies Of The Process Of Brea
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Author : Wing-Tak Wendy Lam
language : en
Publisher: Open Dissertation Press
Release Date : 2017-01-27
Studies Of The Process Of Brea written by Wing-Tak Wendy Lam and has been published by Open Dissertation Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017-01-27 with Medical categories.
This dissertation, "Studies of the Process of Breast Cancer Treatment Decision Making and Its Impacts on Short-term Adjustment to Breast Cancer in Chinese Women" by Wing-tak, Wendy, Lam, 藍詠德, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: Abstract of a thesis entitled Studies of the process of breast cancer treatment decision making and its impacts on short-term adjustment to breast cancer in Chinese women submitted by Wendy Wing Tak Lam for the degree of Doctor of Philosophy at the University of Hong Kong June, 2002 Objectives: (1) Describe the process of treatment decision making (TDM) in breast cancer (BC). (2) Explore to what extent women wish to participate in TDM. (3) Identify factors women consider in TDM. (4) Examine how this process affects psychosocial adjustment to BC. Methods: This study had three phases. Phase1 consisted of a qualitative study of 22 women with recently completed breast surgery who completed an in-depth interview designed to study Objective 1. Phase II consisted of a pilot study evaluating the reliability and validity of instruments that measured TDM, self-efficacy (GSeS), patient satisfaction with the medical consultation (MISS), and social adjustment (ChSAS). Phase III consisted of a prospective interviewed-based study designed to study Objectives 2, 3, and 4 with assessment within 5 days, and again at one-month post-surgery. Women completed several instruments including measures of participation satisfaction, choice influence, informational support, expectancy-outcome incongruence (EOI), self-efficacy (GseS), optimism (CLOT-R), psychological morbidity (CHQ-12), social adjustment (ChSAS), and subjective health (CPH and GPH). Subjects: Phases I (N = 22) and III (N = 154): Chinese women recently diagnosed with BC who had completed breast surgery were recruited at six government-funded hospitals. Phase II (N = 226): Chinese women who had a diagnosis of BC and had completed all the associated treatment recruited at a local BC self-help group. Analysis and Findings: Grounded theory analysis of narrative data in Phase I showed that discovery of breast abnormality and emotional responses to BC diagnosis influence the TDM process. The experience of TDM, which was likened to gambling, did not end once the decision was made, but unfolded while waiting for surgery and the post-operative report. Factor analysis was used to assess the construct validity of the instruments in Phase II. Adequate reliability statistics and reasonable construct validity were seen, suggesting the piloted instruments were suitable to use in Phase III. Fifty-nine percent of women in Phase III preferred shared decision-making. Most women had participated as much as they desired, while participation incongruence was associated with having an opportunity to make treatment choices, perceived difficulties and perceived lack of confidence in TDM. Survival was rated as the most important factor women considered in deciding breast surgery. Women having breast conserving surgery rated surgeon's recommendation, sexuality issues, and avoidance of radiation therapy as more important factors in TDM than did women having mastectomy. Results of path analyses indicated that (1) optimism directly effected CHQ-12 and ChSAS, (2) self-efficacy directly effected ChSAS, (3) optimism and self-efficacy indirectly effected CHQ-12 and ChSAS via its effect on EOI, and (4) EOI directly effected CHQ-12 and ChSAS. Optimism had the greatest causal effect on psychosocial adjustment. Post hoc analyses led to the extension of the path model to include severity of physical sympt
Effects Of Alternative Decision Support Technologies On Breast Cancer Patients Knowledge Of Options And Satisfaction With Treatment Decisions
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Author :
language : en
Publisher:
Release Date : 2001
Effects Of Alternative Decision Support Technologies On Breast Cancer Patients Knowledge Of Options And Satisfaction With Treatment Decisions written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2001 with categories.
The objectives of the research are to: (1) develop an innovative computer-based decision support (CDSS) that will enable women with breast cancer to integrate the information available to them, understand diagnoses, treatment options and risks associated with treatment options, construct and structure their preferences, and make important health decisions; and (2) assess the impact of the new CDSS by making it available to women newly diagnosed with breast cancer and comparing it with two other existing technologies and a control group in a carefully designed experiment. The assessment of the impact will be made in terms of understanding of diagnoses, treatment options and risks associated with treatment options, satisfaction with decision made, amount of involvement in decision, compliance with decision, change in health status, and change in quality of life. This report describes the progress made to further enhance and update the CHESS system. The study design and protocol are described as well as the survey data collection process, and the recruitment process. Preliminary survey data results and use data results are reported.
Relationship Between Coping Style Treatment Decision Making Role Preference And Psychological Adjustment In Women With Breast Cancer
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Author : Thomas F. Hack
language : en
Publisher:
Release Date : 1994
Relationship Between Coping Style Treatment Decision Making Role Preference And Psychological Adjustment In Women With Breast Cancer written by Thomas F. Hack and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1994 with categories.