Regret in Surgical Decision Making: A Systematic Review of Patient and Physician Perspectives

Wilson, Ana; Ronnekleiv-Kelly, Sean; Pawlik, Timothy M.

doi:10.1007/s00268-017-3895-9

Cited by 114 publications

(109 citation statements)

References 105 publications

(106 reference statements)

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“…As in Lorenzo et al (2014), parental regret was predicted by several factors, including initial desire to avoid surgery, but not by surgical variables (techniques and practices) or the development of complications. These studies suggest that parents often consent to hypospadias repairs that they later regret, and that regret occurs at a rate that is greater than the one in seven regret rate found in surgical regret studies more broadly (Wilson, Ronnekleiv-Kelly, & Pawlik, 2017). 3 It is possible that medical framing not only shapes parents' consenting to surgery but also shapes their later regret.…”

Section: Framing Parents' Choicesmentioning

confidence: 99%

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Shaping parents, shaping penises: How medical teams frame parents’ decisions in response to hypospadias

Roen

Hegarty

2018

British J Health Psychol

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The best interests of children with hypospadias may well be served when psychological pathways are highlighted, providing opportunities to support the flourishing of children whose genital appearance raises the question of medical intervention. Statement of Contribution What is already known on this subject? Framing significantly affects medical decision-making in ways that people typically fail to perceive. Parents frequently consent to non-essential hypospadias (penile) surgery for their sons, despite the risks and ethical concerns. What does this study add? Medical teams could do more to consider framing when counselling parents about their son's hypospadias. Psychological specialists can help parents to frame their son's penile difference in terms of well-being and love. The best interests of children with hypospadias may be served by highlighting psychological care pathways.

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Section: Framing Parents' Choicesmentioning

confidence: 99%

“…Wilson et al's (2017) work is a review paper covering a wide range of conditions, although most of the studies relate to surgical regret in the context of cancer.…”

mentioning

confidence: 99%

Shaping parents, shaping penises: How medical teams frame parents’ decisions in response to hypospadias

Roen

Hegarty

2018

British J Health Psychol

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“…Along with patients, caregivers are often affected by decision regret in the course or in the aftermath of participating in treatment decisions . Indeed, one study demonstrated that caregivers experiencing decision regret have a lower health‐related quality of life .…”

Section: Introductionmentioning

confidence: 99%

Assessing decision regret in caregivers of deceased German people with cancer—A psychometric validation of the Decision Regret Scale for Caregivers

Haun

Schakowski

Preibsch

et al. 2019

Health Expectations

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Background Decisional regret during or after medical treatments is linked to significant distress. Regret affects not only patients but also caregivers having an active or passive role during decision making. The Decision Regret Scale (DRS) is a self‐report measure for regret in patients after treatment decisions. However, practical and psychometrically robust instruments assessing regret in caregivers are lacking. Objective To develop and validate a caregiver version of the DRS (Decision Regret Scale for Caregivers [DRS‐C]). Design Psychometric validation based on a web survey. Setting and participants 361 caregivers of deceased German people/patients with cancer. Main variables studied Besides structural validity and test‐retest reliability, we evaluated measurement invariance accounting for gender, age and closeness of relationship, and tested hypotheses on convergent/discriminant validity. Results Forty‐five per cent of all caregivers demonstrated decision regret. Confirmatory factor analyses strongly supported the unidimensional structure of the DRS‐C and pointed to strict invariance. The DRS‐C demonstrated very good internal consistency (α = 0.83, 95% CI [0.81, 0.86]) and test‐retest reliability (ICC [A,1] = 0.73, 95% CI [0.59, 0.83]) along with sound convergent/discriminant validity. Concerning responsiveness, DRS‐C scores remained stable over a 12‐week period in 83.3% of all caregivers. Receiver operating characteristic analysis yielded a cut point of 43 for the identification of significant decision regret (AUC = 0.62, 95% CI [0.56, 0.68]). Discussion and conclusions The lack of a gold standard instrument prevented us from examining the criterion validity and determining a minimally important difference. Nevertheless, the DRS‐C provides valid and reliable information regarding caregiver regret following medical decisions. Above all, it captures a crucial aspect of the treatment experience in caregivers.

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“…As a matter of fact, in the review of 73 studies evaluating regret primarily (57.5%) in oncologic patients, the average prevalence of patient regret was found to be 14.4% even though it varied among studies. 31 Health care is a process and there are many decision points in this process. Evaluating the treatment options, making recommendations, and expressing the benefits and risks require more than a knowledgeable and experienced surgeon.…”

Section: Decision Making Processmentioning

confidence: 99%

Decision Making in Surgical Oncology

Yalaza¹,

Akgül²

2018

TJCD

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Eski Mısır yazmalarından anlaşıldığı üzere kanser en azından 3,500 yıldır önemli bir sağlık sorunudur. Artan bilgi birikimi ve teknolojik yeniliklerle birlikte kansere karşı yapılan mücadelede önemli başarılar elde edilmiştir. Ancak kanser tüm dünyada ölümlerin hala önde gelen nedenlerindendir. Son yüzyılda genetik ve histopatolojik çalışmalarla hastalığın doğası daha iyi anlaşılırken, onkoloji kimi anabilim dallarında cerrahi onkoloji örneğinde olduğu gibi bir bilim dalı olmuştur. Kanser hastalarında karar verme süreci üzerinde çeşitli çalışmalar yapılmış doğru karar vermenin hastalığın iyi yönetimi için gerekli olduğu üzerinde durulmuştur. Bu makalede amacımız bilinenlerden hareketle bu önemli konuda ilave çalışmaların yapılması için zemin oluşturmak, karar alma sürecinin zorluklarını anlama ve bunları aşma konusunda kat edilmesi gereken bir yolun varlığına vurgu yapmaktır. Anahtar Kelimeler: Karar verme, cerrahi, karar destek sistemleri ÖZ ABSTRACTAs can be seen from ancient Egyptian writings, cancer has been a major health problem for at least 3.500 years. Significant progress has been achieved in the battle against cancer in conjunction with increased knowledge and technological developments. However, cancer remains one of the leading causes of deaths worldwide. In the last century, as genetics and histopathological studies have fostered our understanding of the nature of the disease, oncology has become a subdiscipline within some of the major medical branches, i.e. surgical oncology. Several studies have been conducted on the decision-making process in cancer patients and it has been emphasized that correct decision-making is essential for proper management of the disease. In this article, we aimed to create a foundation based on what we already know on this important issue, to understand the difficulties of the decisionmaking process, and to emphasize the developments needed to overcome these difficulties.

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Regret in Surgical Decision Making: A Systematic Review of Patient and Physician Perspectives

Abstract: Self-reported decisional regret was present in about 1 in 7 surgical patients. Factors associated with regret were both patient- and procedure related. While most studies focused on patient regret, little data exist on how physician regret affects shared decision making.

Cited by 114 publications

References 105 publications

Shaping parents, shaping penises: How medical teams frame parents’ decisions in response to hypospadias

Shaping parents, shaping penises: How medical teams frame parents’ decisions in response to hypospadias

Assessing decision regret in caregivers of deceased German people with cancer—A psychometric validation of the Decision Regret Scale for Caregivers

Decision Making in Surgical Oncology

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