Decisions about treatment: interpretations of two measures of control by women having a hysterectomy

Entwistle, Vikki; Skea, Zoë; O'Donnell, M

doi:10.1016/s0277-9536(00)00382-8

Cited by 64 publications

(64 citation statements)

References 19 publications

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“…Using these two scales, Entwistle, Skea and O'Donnell (38) found that patients picked the same roles for differing reasons, and some picked differing roles for similar reasons when compared to their narrative accounts, and hence questioned the validity of these scales.…”

Section: Measuring Autonomous Choicementioning

confidence: 99%

Trust, choice and power in mental health

Laugharne

Priebe

2006

Soc Psychiat Epidemiol

134

116

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Trust, choice and empowerment of patients are emerging as important issues in mental health care. This may be due to an increasingly consumerist attitude amongst patients and as a consequence of postmodern cultural changes in society. This study aimed to find evidence for the influence of trust, patient choice and patient empowerment in mental health care. A literature review was undertaken. Six searches of PubMed were made using the key terms trust, patient choice and power combined separately with psychiatry and mental health. The literature search found substantial research evidence in the areas of trust, choice and power including validated scales measuring these concepts and evidence that they are important to patients. Trust in general health clinicians was found to be high and continuity of care increases Declaration of interestBoth authors are psychiatrists working in the UK.

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Section: Measuring Autonomous Choicementioning

confidence: 99%

Trust, choice and power in mental health

Laugharne

Priebe

2006

Soc Psychiat Epidemiol

134

116

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“…One example is young women with hemorrhagic problems preferring hysterectomy. Entwistle et al 30 illustrated how some of these women have found it difficult to persuade their general practitioner to refer them to a specialist or to persuade their consultants to provide their preferred hysterectomy. Our view is that that explicit attention to each of the three subcategories for each category in Table 4 provides a way out of such controversies.…”

Section: Did As I Was Told and Accepted The Treatment They Told Me mentioning

confidence: 99%

Four categories of patient participation in treatment and their linkage to decision-making in a structure of 81 models

Heggland

Hausken

2015

Nurs Rep

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We clarify patient participation by developing a systematic structure of 3 4 =81 models spanned out by three subcategories for each of four categories. Choosing a qualitative descriptive research design, and applying purposive sampling, four doctors, seven nurses, and seven patients were selected to ensure a broad representative sample with experts of varying ages and sexes from medicine and nursing. The preferences of these were mapped onto the theoretical structure. Applying content analysis, meaning units were identified, condensed and coded. The four categories information dissemination, formulation of options, integration of information and control were shown to be exhaustive, and mutually exclusive through time causing a topdown process where one occurs before the other through four stages. The three subcategories specify how patients, healthcare professionals, or both, operate within each category. That is, either patients are active in some sense that is specified, or healthcare professionals are active in some sense, or both are active. Delineating a structure of 3 4 =81 models, based on four categories and three subcategories, gives a richer structure than what has earlier been available. This almost all-embracing structure enables pinpointing the exact nature of any culture involved in care of patients, which illuminates how the culture reflects or can potentially be altered to reflect values of patient care that we respect.

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“…For example, a small study examining the ability of patients to categorize the role they played in decision making (ie, passive, shared, and active) showed little correlation between patient reports and survey responses. 61 Another important area in need of further research is examining whether SDM is associated with changes in the use or improvements in health outcomes. Some studies suggest that patients who are more engaged and involved in selecting treatments will have better adherence or perhaps less use of invasive procedures; however, the data are limited.…”

Section: Current Opportunitiesmentioning

confidence: 99%

Measuring Shared Decision Making

Sepucha

Scholl

2014

Circ: Cardiovascular Quality and Outcomes

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In the past few decades, patient-centeredness has gained in importance, 1,2 and policies to promote patient-centered care have been increasing.3 Several different models of patient-centered care have been described. Although these models vary on their specific definitions and dimensions, they all emphasize the importance of facilitating the engagement of patients in their own healthcare decisions. 1,4,5 In some cases, facilitating patient engagement in decisions focuses on ensuring patients receive proven, effective care and do not receive proven, ineffective care. In cardiology, these situations often correspond to American College of Cardiology/American Heart Association class I or III recommendations with strong evidence, and the quality of decisions can be measured by the percentage of eligible patients who receive care that is consistent with the guidelines. Several quality measures endorsed by the National Quality Forum for cardiovascular care fall into these situations, such as the percentage of patients who receive β-blockers at discharge from cardiac surgery or persistence of β-blocker usage after a heart attack except for those patients at low risk.However, even in situations with class I recommendations, some questions arise in implementing these recommendations into clinical care. For example, the high nonadherence rates for β-blocker therapy (or statin therapy) suggest that patients think differently about the tradeoffs between the potentially modest survival gain and the side effects of the therapy. 6,7 In these cases, is it acceptable for patients to decline therapy, and if so, what if any documentation might we need to be confident that the decision was informed and high quality?As Brindis and Walsh 8 highlight in their presidential address, decisions, such as the use of statins for primary prevention, treatment of atrial fibrillation, valve replacement (eg, the use of tissue or mechanical valves), and use of implantable cardiac defibrillators, are all common ones for which there is not one clear best choice. In these situations, patients and providers need to consider the evidence and preferences of individual patients to select a treatment. Understanding and measuring the quality of decisions when there are multiple appropriate options require more than examining treatment rates.One approach that supports increased patient engagement in medical decision making is the model of shared decision making (SDM). The concept of SDM was first described in the 1980s 9,10 and is an interactive process between patients (and family members) and the healthcare team to ensure that decisions are evidence based and patient centered. The key elements of SDM in the visit include defining and explaining the problem, helping patients (and providers) to recognize that a decision needs to be made, presenting options, discussing the pros and cons (ie, the outcomes in terms of benefits and risks and costs) of each option, eliciting patients' goals and concerns (ie, finding out what matters most to them), discussing the...

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Decisions about treatment: interpretations of two measures of control by women having a hysterectomy

Cited by 64 publications

References 19 publications

Trust, choice and power in mental health

Trust, choice and power in mental health

Four categories of patient participation in treatment and their linkage to decision-making in a structure of 81 models

Measuring Shared Decision Making

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