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  • 1
    In: Medical Decision Making, SAGE Publications
    Abstract: While shared decision making (SDM) is advocated for ethical reasons and beneficial outcomes, SDM might also negatively affect patients with incurable cancer. The current study explored whether SDM, and an oncologist training in SDM, are associated with adverse outcomes (i.e., patient anxiety, tension, helplessness/hopelessness, decisional uncertainty, and reduced fighting spirit). Design A secondary analysis of a randomized clinical trial investigating the effects of SDM interventions in the context of advanced cancer. The relations between observed SDM (OPTION12), specific SDM elements (4SDM), oncologist SDM training, and adverse outcomes were analyzed. We modeled adverse outcomes as a multivariate phenomenon, followed by univariate regressions if significant. Results In total, 194 patients consulted by 31 oncologists were included. In a multivariate analysis, observed SDM and adverse outcomes were significantly related. More specifically, more observed SDM in the consultation was related to patients reporting more tension ( P = 0.002) and more decisional uncertainty ( P = 0.004) at 1 wk after the consultation. The SDM element “informing about the options” was especially found to be related to adverse outcomes, specifically to more helplessness/hopelessness ( P = 0.002) and more tension ( P = 0.016) at 1 wk after the consultation. Whether the patient consulted an oncologist who had received SDM training or not was not significantly related to adverse outcomes. No relations with long-term adverse outcomes were found. Conclusions It is important for oncologists to realize that for some patients, SDM may temporarily be associated with negative emotions. Further research is needed to untangle which, when, and how adverse outcomes might occur and whether and how burden may be minimized for patients. Highlights Observed shared decision making was related to more tension and uncertainty postconsultation in advanced cancer patients However, training oncologists in SDM did not affect adverse outcomes. Further research is needed to untangle which, when, and how adverse outcomes might occur and how burden may be minimized
    Type of Medium: Online Resource
    ISSN: 0272-989X , 1552-681X
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2040405-0
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  • 2
    In: Patient Education and Counseling, Elsevier BV, Vol. 112 ( 2023-07), p. 107712-
    Type of Medium: Online Resource
    ISSN: 0738-3991
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 2019572-2
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  • 3
    In: Journal of Advanced Nursing, Wiley, Vol. 77, No. 1 ( 2021-01), p. 296-307
    Abstract: 研究医院护士对延长生命治疗共同决策的实际贡献和潜在贡献的认识,以及对此类贡献前提条件的认识。 设计 定性访谈研究。 方法 对18名医院护士进行半结构化的面对面访谈,这些护士均参与了患有命危疾病患者的护理工作。收集2018年10月至2019年1月之间的数据。两名研究员对访谈内容进行录制、逐字转录和主题分析。 结果 护士对延长生命治疗决策有着不同程度的影响作用。此外,我们确定了护士在治疗过程中可以参与治疗决策的不同接触点。护士对可能促进共同决策行为的可描述为以下三个角色:检查决策质量、对共同决策进行补充和促进共同决策。履行本研究中确定角色作用的先决条件是:(a)护士之间以及护士和其他保健专业人员之间的信息传递;(b)对护士参与决策持积极态度的文化;(c)与医生的良好关系;(d)知识和技能;(e)充裕的时间;以及(f)与患者的良好关系。 结论 护士会说明能反映对患者延长生命治疗共同决策中起到支持作用的行为,尽管并非所有护士都会经历此类参与过程。护士可以通过检查决策质量、补充和促进共同决策来增强在共同决策过程中的作用。 影响 护士在共同决策过程中的作用越来越大。为促进他们的贡献,未来的研究应侧重于护士参与治疗决策的影响可能性,以及循证培训,以提高他们对于其如何发挥这一作用的认识并提供相关指导。
    Type of Medium: Online Resource
    ISSN: 0309-2402 , 1365-2648
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2009963-0
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  • 4
    In: Psycho-Oncology, Wiley, Vol. 32, No. 6 ( 2023-06), p. 904-912
    Abstract: To describe young adult childhood cancer survivors' disclosure of their cancer history (i.e., disclosure behavior, difficulty, and timing), perceived partner responses, and associations with relationship status satisfaction. Methods German long‐term survivors of childhood cancer ( N  = 509; response rate: 31.3%, age 21–26, 59.7% female) completed a registry‐based nationwide survey (embedded mixed methods design, including closed and open‐ended questions) on measures about disclosure history (behavior, difficulty, and timing), partner responses, and relationship status satisfaction. Statistical ( χ 2 ‐, t ‐, or F ‐tests) and qualitative analyses were conducted. Results Half of all survivors always disclosed their cancer history to romantic partners. Thereby, three themes for considering (non‐)disclosure were identified: Survivors' attitudes, having integrated cancer as part of their identity, and anticipated effects on romantic relationships. About 40% indicated having no difficulties with disclosing their cancer history. The timing of disclosure varied, with most survivors disclosing after a few dates. Facilitators of disclosure were the visibility of their former illness (e.g., scars), having trust in a (potential) partner, getting older/mature, and previous positive experiences with disclosure. Few survivors (13.8%) had ever experienced negative responses from dating partners. Yet, those who had negative experiences, found it more difficult to disclose their cancer history. Survivors were overall rather satisfied with their relationship status, with partnered survivors reporting greater satisfaction than singles (Hedge's g  = 1.68); and particularly partnered survivors with past positive responses being most satisfied. Conclusions Young adult childhood cancer survivors appear rather open in disclosing their cancer history to (potential) romantic partners, and few experienced negative responses. Psycho‐educational programs may emphasize such findings in helping to prevent fear of disclosure or avoidance of dating and disclosure among survivors.
    Type of Medium: Online Resource
    ISSN: 1057-9249 , 1099-1611
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 1495115-0
    SSG: 5,2
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  • 5
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Current Opinion in Supportive & Palliative Care Vol. 13, No. 1 ( 2019-03), p. 33-45
    In: Current Opinion in Supportive & Palliative Care, Ovid Technologies (Wolters Kluwer Health), Vol. 13, No. 1 ( 2019-03), p. 33-45
    Abstract: Effective communication in cancer care requires complex communication skills of healthcare professionals (HCPs), which can be advanced by communication skills training (CST). The number of empirical studies on CST has grown steadily over the last decade. However, controversies on CST abound. The aim of this review of reviews is to summarize evidence for the effectiveness of CST in oncology as well as for effective CST features (intensity, format and content) and to synthesize the current opinion on CST. Recent findings The evidence synthesized from multiple reviews supported the effect of CST on HCPs’ communication skills. Yet, the certainty of evidence was limited as studies were diverse and effects heterogeneous. Furthermore, limited evidence was found for effective CST intensity, format and content. Authors of the reviews advocated further high-quality research with robust outcome measurement to establish the most essential features of CST and recommended implementation of CST in the standard training of HCPs with continuous supervision. Summary CST can probably improve some aspects of HCPs’ communication skills. Despite the uncertain evidence, implementation of CST into clinical practice is widely advocated and specific recommendations regarding intensity and format are provided. Evidence to justify and substantiate implementation efforts is needed.
    Type of Medium: Online Resource
    ISSN: 1751-4258 , 1751-4266
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
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  • 6
    In: British Journal of General Practice, Royal College of General Practitioners, Vol. 72, No. 717 ( 2022-04), p. e276-e284
    Abstract: GPs are well placed to enhance shared decision making (SDM) about treatment for patients with advanced cancer. However, to date, little is known about GPs’ views about their contribution to SDM. Aim To explore GPs’ perspectives on their role in SDM about palliative cancer treatment and the requirements they report to fulfil this role. Design and setting Qualitative interview study among Dutch GPs. Method GPs were sampled purposefully and conveniently. In-depth, semi-structured interviews were conducted, recorded, and transcribed verbatim. Transcripts were analysed by thematic analysis. Results Fifteen GPs took part in this study. Most of them reported practices that potentially support SDM: checking the quality of a decision, complementing SDM, and enabling SDM. Even though most of the GPs believed that decision making about systemic cancer treatment is primarily the oncologist’s responsibility, they did recognise their added value in the SDM process because of their gatekeeper position, the additional opportunity they offer patients to discuss treatment decisions, and their knowledge and experience as primary healthcare providers at the end of life. Requirements for them to support the SDM process were described as: good collaboration with oncologists; sufficient information about the disease and its treatment; time to engage in conversations about treatment; a trusting relationship with patients; and patient-centred communication. Conclusion GPs may support SDM by checking the quality of a decision and by complementing and enabling the SDM process to reach high-quality decisions. This conceptualisation of the GP’s supporting role in SDM may help us to understand how SDM is carried out through interprofessional collaboration and provide tools for how to adopt a role in the interprofessional SDM process.
    Type of Medium: Online Resource
    ISSN: 0960-1643 , 1478-5242
    RVK:
    Language: English
    Publisher: Royal College of General Practitioners
    Publication Date: 2022
    detail.hit.zdb_id: 2097982-4
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