Decision Making in a Crowded Room

Forsyth, Rowena; Scanlan, Camilla Louise; Carter, Stacy M; Jordens, Christopher F. C.; Kerridge, Ian

doi:10.1177/1049732311405802

Cited by 23 publications

(25 citation statements)

References 46 publications

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“…It is difficult to discuss principles for engagement without considering the context in which these principles would be implemented and the barriers and facilitators that impact patient engagement at the system(s) level. Resources (e.g., time and money) are necessary for a system to support patient engagement [ 3 , 36 , 51 , 54 , 55 ]. A shift in organizational structure is essential to allow patients and their social support network to be engaged in meaningful partnerships.…”

Section: Resultsmentioning

confidence: 99%

Engaging Older Adults in Health Care Decision-Making: A Realist Synthesis

Elliott

McNeil

Ashbourne

et al. 2016

Patient

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BackgroundEngagement in healthcare decision making has been recognized as an important, and often lacking, aspect of care, especially in the care of older adults who are major users of the healthcare system.ObjectiveWe aimed to conduct a review of available knowledge on engagement in healthcare decision making with a focus on older patients and their caregivers.MethodsWe conducted a realist synthesis focusing on strategies for engagement of older patients and their caregivers in healthcare decision making. The synthesis encompassed theoretical frameworks and both peer-reviewed and grey literature. Expert consultations included interviews (n = 2) with academics and group consultations (n = 3) with older adults and their caregivers. Abstracts that reported description, assessment, or evaluation of strategies for engagement of adult patients, families, or caregivers (i.e., that report on actual experiences of engagement) were included.ResultsThe search generated 15,683 articles, 663 of which were pertinent to healthcare decision making. Theoretical and empirical work identified a range of strategies and levels of engagement of older patients and their families in healthcare decision making. The importance of communication emerged as a key recommendation for meaningful engagement among providers and patients and their caregivers. The principles developed in this study should be implemented with consideration of the context in which care is being provided.ConclusionsWe have developed a framework that promotes the engagement of patients and their caregivers as equal partners in healthcare decision making. Future research should implement and test the framework in various clinical settings.Electronic supplementary materialThe online version of this article (doi:10.1007/s40271-016-0168-x) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Engaging Older Adults in Health Care Decision-Making: A Realist Synthesis

Elliott

McNeil

Ashbourne

et al. 2016

Patient

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“…In making complex medical decisions, patients may balance relationships of mutual obligation with nurses, physicians, and their own social networks (Forsyth, Scanlan, Carter, Jordens, & Kerridge, 2011). Providers' communication practices may shape mothers' decision making, autonomy, and satisfaction with the birth experience.…”

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confidence: 99%

Nurses’ Perspectives on the Intersection of Safety and Informed Decision Making in Maternity Care

Jacobson¹,

Zlatnik²,

Kennedy³

et al. 2013

Journal of Obstetric, Gynecologic & Neonatal Nursing

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Objective To explore maternity nurses' perceptions of women's informed decision making during labor and birth to better understand how interdisciplinary communication challenges might affect patient safety. Design Constructivist grounded theory. Setting Four hospitals in the Western United States. Participants Forty six (46) nurses and physicians practicing in maternity units. Methods Data collection strategies included individual interviews and participant observation. Data were analyzed using the constant comparative method, dimensional analysis, and situational analysis (Charmaz, 2006; Clarke, 2005; Schatzman, 1991). Results The nurses' central action of holding off harm encompassed three communication strategies: persuading agreement, managing information, and coaching of mothers and physicians. These strategies were executed in a complex, hierarchical context characterized by varied practice patterns and relationships. Nurses' priorities and patient safety goals were sometimes misaligned with those of physicians, resulting in potentially unsafe communication. Conclusions The communication strategies nurses employed resulted in intended and unintended consequences with safety implications for mothers and providers and had the potential to trap women in the middle of interprofessional conflicts and differences of opinion.

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“…Forsyth et al . 21 conducted a qualitative study to investigate decision making in allogeneic HCT through in-depth interviews with patients, their significant others and transplant physicians, and in addition to the factors described above highlighted a number of social factors that will direct their decision to undergo transplant. These included particular family milestone events, the family's reliance on them, family support for/against HCT and the existence of a support network outside of immediate family as factors implicated in patient's decision making.…”

Section: Introductionmentioning

confidence: 99%

“…These included particular family milestone events, the family's reliance on them, family support for/against HCT and the existence of a support network outside of immediate family as factors implicated in patient's decision making. 21 …”

Section: Introductionmentioning

confidence: 99%

Is ‘informed consent’ an ‘understood consent’ in hematopoietic cell transplantation?

D’Souza

Pasquini

Spellecy

2014

Bone Marrow Transplant

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Hematopoietic cell transplantation (HCT) is a complex and highly specialized medical treatment that is associated with significant risks, including death. Furthermore, transplantation is offered to patients who often have no other curative treatment alternatives. The routine-consent process for HCT typically occurs before HCT and is influenced by many factors related to patients, physicians and the transplant per se. These factors can impede the consent process and subsequently result in a failure of proper engagement in and an understanding of the procedure with resultant adverse consequences influencing patients and even the patient–physician relationship. We contend that informed consent is a dynamic and ongoing process and that better patient education can assist in the decision making, fulfill the ethical principle of respect for autonomy and engage the patient to maximize compliance and adherence to therapy. This manuscript reviews the key literature pertaining to the decision-making and consent process in HCT and proposes guidelines for improving the consent process. Strategies for improving patient comprehension, engagement and enhancing consent forms are discussed.

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Decision Making in a Crowded Room

Cited by 23 publications

References 46 publications

Engaging Older Adults in Health Care Decision-Making: A Realist Synthesis

Engaging Older Adults in Health Care Decision-Making: A Realist Synthesis

Nurses’ Perspectives on the Intersection of Safety and Informed Decision Making in Maternity Care

Is ‘informed consent’ an ‘understood consent’ in hematopoietic cell transplantation?

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