2.50
Hdl Handle:
http://hdl.handle.net/10755/157656
Type:
Presentation
Title:
Preferred and Actual Level of Participation During Treatment Decisions
Abstract:
Preferred and Actual Level of Participation During Treatment Decisions
Conference Sponsor:Western Institute of Nursing
Conference Year:2009
Author:Tariman, Joseph D., PhC, RN, MN, ARNP, BC, OCN
P.I. Institution Name:University of Washington, Biobehavioral Nursing and Health Systems
Title:Pre-doctoral Fellow
Contact Address:917 N 72nd Street, Seattle, WA, 98103, USA
Contact Telephone:206-437-2328
Purpose: 1. Systematically examine and present both the preferred and actual levels of participation in decision making among adult patients with cancer. 2. Compare and contrast the various methods used in the measurement of patients' preferred and actual level of participation. Rationale/Background: Patients are involved in health care decisions more than ever. The process of treatment decision making continues to be investigated particularly among patients with breast and prostate cancers and increasingly in patients with colorectal, gynecological, and other cancers. These increases in decision making studies can be attributed to the initial empirical evidence that individuals who exercise control over decisions regarding their treatment have better outcomes (i.e. satisfaction with decision, better psychological adjustment). Methods and Analysis: A systematic review was performed to identify studies which examined preferred and actual level of participation, and the match between preferred and actual roles in decision making among patients with cancer. PubMed (1966-July 2008), PsycInfo (1967-July 2008) and CINAHL (1982-July 2008) databases were searched to access relevant medical, psychological and nursing literature. The key terms used were decision making, oncology, patient participation, and role preferences. The search was limited to articles concerning adults and English language only. Outcomes Achieved/Documented: Eleven studies involved patients with breast cancer four studies with prostate, three studies with various types of cancer, two studies with colorectal cancer, one study with lung cancer, and one study with various gynecological cancers. Twenty out of the twenty two studies utilized the Control Preferences Scale tool to elicit the patient's perceived or actual role in decision making. The other two studies utilized an investigator-developed treatment decision making questionnaire. Psychometric properties of the CPS scale were adequate; no report on psychometric properties of the investigator-developed treatment decision making questionnaire. All studies revealed discrepancies between preferred and actual or perceived role in decision making. Across all cancer types, the majority of the studies found that patients wanted more involvement than what they were able to actualized. Only three (all with prostate cancers) out of twenty two studies reported that patients wanted less involvement than what was actualized. Patients with various cancers have also reported less involvement than what they originally preferred. These groups of patients wanted a more shared to active role and less passive role. Similarly, majority of patients with breast cancer also wanted more actual involvement than what they originally preferred. Conclusions/Recommendations: The limited concordance between patients' preferred and actual role assumed during decision making have indicated that we need to raise the sensitivity of the clinicians regarding patient's participation in health care decisions. Clinicians should be trained on how to improve their communication skills that can promote a patient's communication of needs and desires.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titlePreferred and Actual Level of Participation During Treatment Decisionsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157656-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Preferred and Actual Level of Participation During Treatment Decisions</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Tariman, Joseph D., PhC, RN, MN, ARNP, BC, OCN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Washington, Biobehavioral Nursing and Health Systems</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Pre-doctoral Fellow</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">917 N 72nd Street, Seattle, WA, 98103, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">206-437-2328</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">jtariman@u.washington.edu, phdinseattle@yahoo.com</td></tr><tr><td colspan="2" class="item-abstract">Purpose: 1. Systematically examine and present both the preferred and actual levels of participation in decision making among adult patients with cancer. 2. Compare and contrast the various methods used in the measurement of patients' preferred and actual level of participation. Rationale/Background: Patients are involved in health care decisions more than ever. The process of treatment decision making continues to be investigated particularly among patients with breast and prostate cancers and increasingly in patients with colorectal, gynecological, and other cancers. These increases in decision making studies can be attributed to the initial empirical evidence that individuals who exercise control over decisions regarding their treatment have better outcomes (i.e. satisfaction with decision, better psychological adjustment). Methods and Analysis: A systematic review was performed to identify studies which examined preferred and actual level of participation, and the match between preferred and actual roles in decision making among patients with cancer. PubMed (1966-July 2008), PsycInfo (1967-July 2008) and CINAHL (1982-July 2008) databases were searched to access relevant medical, psychological and nursing literature. The key terms used were decision making, oncology, patient participation, and role preferences. The search was limited to articles concerning adults and English language only. Outcomes Achieved/Documented: Eleven studies involved patients with breast cancer four studies with prostate, three studies with various types of cancer, two studies with colorectal cancer, one study with lung cancer, and one study with various gynecological cancers. Twenty out of the twenty two studies utilized the Control Preferences Scale tool to elicit the patient's perceived or actual role in decision making. The other two studies utilized an investigator-developed treatment decision making questionnaire. Psychometric properties of the CPS scale were adequate; no report on psychometric properties of the investigator-developed treatment decision making questionnaire. All studies revealed discrepancies between preferred and actual or perceived role in decision making. Across all cancer types, the majority of the studies found that patients wanted more involvement than what they were able to actualized. Only three (all with prostate cancers) out of twenty two studies reported that patients wanted less involvement than what was actualized. Patients with various cancers have also reported less involvement than what they originally preferred. These groups of patients wanted a more shared to active role and less passive role. Similarly, majority of patients with breast cancer also wanted more actual involvement than what they originally preferred. Conclusions/Recommendations: The limited concordance between patients' preferred and actual role assumed during decision making have indicated that we need to raise the sensitivity of the clinicians regarding patient's participation in health care decisions. Clinicians should be trained on how to improve their communication skills that can promote a patient's communication of needs and desires.</td></tr></table>en_GB
dc.date.available2011-10-26T20:04:43Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:04:43Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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