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Tytuł pozycji:

Decisional Conflict During Major Medical Treatment Decision-making: a Survey Study.

Tytuł:
Decisional Conflict During Major Medical Treatment Decision-making: a Survey Study.
Autorzy:
Pecanac KE; School of Nursing, University of Wisconsin-Madison, , 701 Highland Ave, Madison, WI, 53705, USA. .
Brown RL; School of Nursing, University of Wisconsin-Madison, , 701 Highland Ave, Madison, WI, 53705, USA.
Kremsreiter HB; School of Nursing, University of Wisconsin-Madison, , 701 Highland Ave, Madison, WI, 53705, USA.
Źródło:
Journal of general internal medicine [J Gen Intern Med] 2021 Jan; Vol. 36 (1), pp. 55-61. Date of Electronic Publication: 2020 Aug 17.
Typ publikacji:
Journal Article; Research Support, Non-U.S. Gov't
Język:
English
Imprint Name(s):
Publication: Secaucus, NJ : Springer
Original Publication: [Philadelphia, PA] : Hanley & Belfus, [c1986-
MeSH Terms:
Clinical Decision-Making*
Parents*
Comprehension ; Decision Making ; Humans ; Surveys and Questionnaires ; Wisconsin
References:
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Garvelink MM, Boland L, Klein K, et al. Decisional conflict scale findings among patients and surrogates making health decisions: Part II of an anniversary review. Med Decis Making. 2019;39:315-326. (PMID: 10.1177/0272989X19881551)
Heyland DK, Heyland R, Dodek P, et al. Discordance between patients’ stated values and treatment preferences for end-of-life care: Results of a multicentre survey. BMJ Support Palliat Care. 2017;7:292-299. (PMID: 10.1136/bmjspcare-2017-00133.79)
O’Connor AM. User manual—decisional conflict scale, 2010, Available at: https://decisionaid.ohri.ca/docs/develop/User_Manuals/UM_Decisional_Conflict.pdf . Accessed Mar 3, 2020.
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Contributed Indexing:
Keywords: decision-making; decisional conflict; health literacy; survey
Entry Date(s):
Date Created: 20200819 Date Completed: 20210521 Latest Revision: 20220524
Update Code:
20240104
PubMed Central ID:
PMC7431116
DOI:
10.1007/s11606-020-06125-1
PMID:
32808213
Czasopismo naukowe
Background: Both patients and surrogate decision-makers experience decisional conflict when making a major medical treatment decision with life or death implications. The relationship between health literacy and decisional conflict while making a major medical treatment decision is not understood.
Objective: To identify the prevalence of individuals making major medical treatment decisions for themselves or someone else and to explore the relationships between decisional conflict and circumstances of the decision as well as the decision-maker.
Design: Two-phase survey study: in phase 1, we screened for who made a major treatment decision; in phase 2, we asked eligible respondents about their experience making the decision.
Participants: Address-based random sample of 4000 Wisconsin residents; 1072 completed phase 1 and 464 completed phase 2.
Main Measures: We asked respondents about types of decisions made, the most difficult decision made, and characteristics of the decision-maker and the decision. We included the Decisional Conflict Scale and four domains of the Health Literacy Questionnaire. Open-ended questions also allowed respondents to describe their experiences.
Key Results: About 43% of respondents reported making a major medical treatment decision. Decisions about major surgery and life support were regarded as the most difficult decisions. Respondents who made the decision for a spouse/partner (β = 6.65, p = 0.012), parent (β = 9.27, p < 0.001), or someone else (β = 10.7, p < 0.001) had higher decisional conflict. Respondents who reported higher ability to actively engage with healthcare providers (β = - 5.24, p = 0.002) and to understand health information well enough to know what to do (β = - 6.12, p = 0.001) had lower decisional conflict.
Conclusions: The need to make major treatment decisions is likely to increase and making decisions on someone else's behalf appeared to be especially difficult. Improving communication to encourage patient and family engagement in the decision-making conversation, particularly for individuals with limited health literacy, may be helpful.

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