Factors Influencing Proxy Decision Making in Mental Retardation (MR): A Feasibility Study

2.50
Hdl Handle:
http://hdl.handle.net/10755/163428
Category:
Abstract
Type:
Presentation
Title:
Factors Influencing Proxy Decision Making in Mental Retardation (MR): A Feasibility Study
Author(s):
Fisher, Kathleen M.; Orkin, Fredrick K.
Author Details:
Kathleen M. Fisher, PhD, CRNP, Associate Professor, Drexel University College of Nursing & Health Professions, Philadelphia, Pennsylvania, USA, email: kmf43@drexel.edu; Fredrick K. Orkin, MD, MBA, MSc
Abstract:
Purpose: To test the feasibility of conjoint analysis in examining proxy decision-making for those with MR to improve understanding of how these decisions are made. Theoretical Framework: Decision making theory. We will discuss criticisms of decision-making theory including charges it does not pertain to real world decisions or that it does not identify the optimal decision. Methods (Design, Sample, Setting, Measures, Analysis): A convenience sample of 23 ED nurses assumed the role of decision maker for an MR individual with a known dental abscess, requiring its extraction, and need for anesthesia i.e. a "minor" surgical procedure. Conjoint analysis was applied to variables nurses ranked in the clinical scenario revealing the relative importance of different clinical factors. Results: Two nurses found the ranking task too complicated. Among the 21 who completed the exercise, the mean "importance" attributed to each factor in their decision making were Likely Future Health status (39%). Family Input (19%), Person's Age (13%), Extra Cost to Agency (12%), Functional Status (10%), and Mental Competence (6%). Nurse subgroups, maintained discrete decision-making patterns, including: 10 nurses (48% of group) relied largely on Future Health Status, 8 nurses (38%) emphasized Future Health Status and Family Input, one nurse focused on Future Health Status and Person's Age, one nurse relied on Mental Competence and Functional Status, and the remaining nurse used Extra Cost to Agency supplemented by Person's Age. Nurse's age, education, years' experience, and work site did not discriminate among evaluative patterns. Conclusions and Implications: The simulation task was feasible and meaningful. Nurses used subsets of information in decision-making, and almost all of the nurses (95%) made decisions on the basis of factors relating to the MR person rather than external issues (i.e., extra cost to agency). This feasibility study provided data for an NIH (NINR) funded study currently underway on proxy decision makers across a northeastern state.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2006
Conference Name:
18th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
Cherry Hill, New Jersey
Description:
�New Momentum for Nursing Research: Multidisciplinary Alliances�, held on April 20th -22nd at the Hilton in Cherry Hill, New Jersey
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleFactors Influencing Proxy Decision Making in Mental Retardation (MR): A Feasibility Studyen_GB
dc.contributor.authorFisher, Kathleen M.en_US
dc.contributor.authorOrkin, Fredrick K.en_US
dc.author.detailsKathleen M. Fisher, PhD, CRNP, Associate Professor, Drexel University College of Nursing & Health Professions, Philadelphia, Pennsylvania, USA, email: kmf43@drexel.edu; Fredrick K. Orkin, MD, MBA, MScen_US
dc.identifier.urihttp://hdl.handle.net/10755/163428-
dc.description.abstractPurpose: To test the feasibility of conjoint analysis in examining proxy decision-making for those with MR to improve understanding of how these decisions are made. Theoretical Framework: Decision making theory. We will discuss criticisms of decision-making theory including charges it does not pertain to real world decisions or that it does not identify the optimal decision. Methods (Design, Sample, Setting, Measures, Analysis): A convenience sample of 23 ED nurses assumed the role of decision maker for an MR individual with a known dental abscess, requiring its extraction, and need for anesthesia i.e. a "minor" surgical procedure. Conjoint analysis was applied to variables nurses ranked in the clinical scenario revealing the relative importance of different clinical factors. Results: Two nurses found the ranking task too complicated. Among the 21 who completed the exercise, the mean "importance" attributed to each factor in their decision making were Likely Future Health status (39%). Family Input (19%), Person's Age (13%), Extra Cost to Agency (12%), Functional Status (10%), and Mental Competence (6%). Nurse subgroups, maintained discrete decision-making patterns, including: 10 nurses (48% of group) relied largely on Future Health Status, 8 nurses (38%) emphasized Future Health Status and Family Input, one nurse focused on Future Health Status and Person's Age, one nurse relied on Mental Competence and Functional Status, and the remaining nurse used Extra Cost to Agency supplemented by Person's Age. Nurse's age, education, years' experience, and work site did not discriminate among evaluative patterns. Conclusions and Implications: The simulation task was feasible and meaningful. Nurses used subsets of information in decision-making, and almost all of the nurses (95%) made decisions on the basis of factors relating to the MR person rather than external issues (i.e., extra cost to agency). This feasibility study provided data for an NIH (NINR) funded study currently underway on proxy decision makers across a northeastern state.en_GB
dc.date.available2011-10-27T11:07:24Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:07:24Z-
dc.conference.date2006en_US
dc.conference.name18th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationCherry Hill, New Jerseyen_US
dc.description�New Momentum for Nursing Research: Multidisciplinary Alliances�, held on April 20th -22nd at the Hilton in Cherry Hill, New Jerseyen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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