The Experts below are selected from a list of 133353 Experts worldwide ranked by ideXlab platform
Dong Wook Shin - One of the best experts on this subject based on the ideXlab platform.
-
patient s cognitive function and attitudes towards Family Involvement in cancer treatment decision making a patient Family caregiver dyadic analysis
Cancer Research and Treatment, 2017Co-Authors: Dong Wook Shin, Debra L. Roter, Jong Hyock Park, Juhee Cho, So Young Kim, Hyung Kook Yang, Hyun Woo Lee, Sunseog Kweon, Yune Sik Kang, Keeho ParkAbstract:Purpose Older patient populations commonly have cognitive impairment, which might impact decisional capacity. We examined patients and Family caregivers preferences for Family Involvement in treatment decision making assuming different level of cognitive impairment, and sought to explore the factors associated with the preferences and the degree to which patients and Family members agree on preferences. Materials and methods A total of 358 elderly cancer patient and caregiver dyads were recruited from the 11 cancer centers in Korea andwere asked to express their preferences forFamily Involvement in treatment decision making using hypothetical scenarios with three different levels of cognitive status (intact, mild impairment, and severe impairment). Results Both patients and Family caregivers preferred greater Family dominance in treatment decision makingwith the increasing the level of cognitive impairment (39.7%, 60.9%, and 86.6% for patients and 45.0%, 66.2%, and 89.7% for caregivers in each scenarios). Patient and Family caregiver concordance in decisional control preference was small for all three scenarios (weighted κ=0.32, κ=0.26, and κ=0.36, respectively). Higher patient education was associated with preference for patient dominance in treatment decision in conditions of both mild and severe cognitive impairment. The association of higher patient education and patient-caregiver preference concordance was positive with intact cognition, while it was negative with severe cognitive impairment. Conclusion Decision control preferences were affected by hypothesized cognitive status of the patients. Findings from our study would be helpful to develop effective strategy for optimizing Family Involvement in cancer treatment decision in the context of deteriorating cognitive function of the patients.
-
attitudes toward Family Involvement in cancer treatment decision making the perspectives of patients Family caregivers and their oncologists
Psycho-oncology, 2017Co-Authors: Debra L. Roter, Dong Wook Shin, Juhee Cho, So Young Kim, Hyung Kook Yang, Keeho Park, Hyung Jin Kim, Heeyoung ShinAbstract:Background To investigate how cancer patients, Family caregiver, and their treating oncologist view the risks and benefits of Family Involvement in cancer treatment decision making (TDM) or the degree to which these perceptions may differ. Patients and Methods A nationwide, multicenter survey was conducted with 134 oncologists and 725 of their patients and accompanying caregivers. Participant answered to modified Control Preferences Scale and investigator-developed questionnaire regarding Family Involvement in cancer TDM. Results Most participants (>90%) thought that Family should be involved in cancer TDM. When asked if the oncologist should allow Family Involvement if the patient did not want them involved, most patients and caregivers (>85%) thought they should. However, under this circumstance, only 56.0% of oncologists supported Family Involvement. Patients were significantly more likely to skew their responses toward patient rather than Family decisional control than were their caregivers (P < .003); oncologists were more likely to skew their responses toward patient rather than Family decisional control than caregivers (P < .001). Most respondents thought that Family Involvement is helpful and neither hamper patient autonomy nor complicate cancer TDM process. Oncologists were largely positive, but less so in these ratings than either patients or caregivers (P < .002). Conclusions Patients, Family caregivers, and, to a lesser degree, oncologists expect and valued Family Involvement in cancer TDM. These findings support a reconsideration of traditional models focused on protection of patient autonomy to a more contextualized form of relational autonomy, whereby the patient and Family caregivers can be seen as a unit for autonomous decision.
-
preferences for and experiences of Family Involvement in cancer treatment decision making patient caregiver dyads study
Psycho-oncology, 2013Co-Authors: Man-soo Yoon, Debra L. Roter, Sang Kyun Sohn, Dong Wook Shin, Jong Hyock ParkAbstract:Background Despite the important role that Family caregivers play in providing emotional and practical support to cancer patients, relatively little is known about the Family caregiver's role in treatment decision-making (TDM). We sought to investigate patients' and Family caregivers' preferences for and experiences of Family Involvement in TDM and factors associated with preference concordance. Method A national survey was performed with 990 patient–caregiver dyads (participation rate:76.2%). Questions examining preferences for and experiences of Family Involvement in TDM were administered independently to patients and Family caregivers. Concordance was calculated with weighted kappa. Logistic regression analyses were used to identify predictors of patients' and caregivers' preferences for Family Involvement in TDM and concordance between them. Results Few patients or Family caregivers expressed a preference for unilateral decision-making; however, there was considerable variation and poor agreement within dyads in regard to whether the patient or Family caregivers should take the lead in decision-making with input from the other (weighted kappa between respondents for TDM preferences and experiences = 0.10 and κ = 0.18, respectively). Greater TDM preference concordance was associated with higher patient education, whereas lower levels of concordance were evident for younger patients, less educated caregivers, adult child patient dyads (as opposed to a spouse–patient dyads) and problematic Family communication about cancer. Conclusions Most patients and Family caregivers valued and expected Family Involvement in TDM. However, there is little explicit agreement in regard to which party in the dyad should take decisional leadership and who should play a supporting role. Copyright © 2013 John Wiley & Sons, Ltd.
Ilona Juraskova - One of the best experts on this subject based on the ideXlab platform.
-
facilitating collaborative and effective Family Involvement in the cancer setting guidelines for clinicians trio guidelines 1
Patient Education and Counseling, 2018Co-Authors: Rebekah Laidsaarpowell, Phyllis Butow, Frances M Boyle, Ilona JuraskovaAbstract:Abstract Objective Family caregivers regularly attend medical consultations and are often involved in decision-making; however, there are few practical strategies to guide effective communication for the clinician-patient-Family trio. We aimed to develop and evaluate the first comprehensive guidelines for oncology physicians and nurses, on how to positively and effectively involve Family caregivers of adult patients in consultations and patient care (TRIO Guidelines-1) and how to manage challenging interactions with Family caregivers (TRIO Guidelines-2). Methods The TRIO Guidelines were based on a comprehensive literature review and input from an expert advisory group (n = 10). They underwent two rounds of formal evaluation via an online Delphi consensus process involving international experts (n = 35), and a subset were piloted with 24 breast cancer clinicians in a workshop format. Results TRIO Guidelines-1 incorporate strategies and sub-strategies on facilitating collaborative and effective Family Involvement (6 topics). Example wording, behaviours, and level of evidence are provided throughout. All 24 clinicians rated the guidelines as helpful after the pilot workshop. Conclusion These guidelines will be a useful educational tool for clinicians and medical/nursing students. Practice implications By equipping clinicians with strategies to facilitate effective and collaborative Family engagement, the TRIO Guidelines have the potential to transform communication in clinical practice.
-
oncologists and oncology nurses attitudes and practices towards Family Involvement in cancer consultations
European Journal of Cancer Care, 2017Co-Authors: Rebekah Laidsaarpowell, Alana Fisher, Phyllis Butow, Ilona JuraskovaAbstract:Family members (FMs) regularly attend cancer consultations with patients, may assume an array of roles (e.g. emotional, informational) and their Involvement may result in benefits and/or challenges. Little is currently known about how oncology health professionals (HPs) view FMs who accompany a patient in consultations. This study aimed to explore the attitudes and practices of Australian oncologists and oncology nurses regarding Family Involvement in consultations. Eleven oncologists and 10 nurses from a range of subspecialties and tumour streams participated in semi-structured interviews. Interviews were transcribed and qualitatively analysed using framework analysis methods. Five relevant themes were identified: (1) the varied and dynamic nature of Family roles during consultations; (2) positivity towards FMs; (3) the benefits of Family Involvement to the FM themselves; (4) current HP practices to facilitate positive Family Involvement; and (5) the challenges of Family Involvement in consultations and HP practices to manage them. Overall, participants held mostly positive attitudes towards Family Involvement. Although they identified a number of challenges which can arise when Family are involved, many noted these situations are the exception, that there are strategies which can help to overcome the challenges, and that the benefits of Family Involvement typically outweigh the costs.
-
Family Involvement in cancer treatment decision making a qualitative study of patient Family and clinician attitudes and experiences
Patient Education and Counseling, 2016Co-Authors: Rebekah Laidsaarpowell, Cathy Charles, Stella Bu, Alana Fisher, Phyllis Butow, Amiram Gafni, Ilona JuraskovaAbstract:Abstract Objective Little is known about how Family are involved in cancer treatment decision-making. This study aimed to qualitatively explore Australian oncology clinicians’, patients’, and Family members’ attitudes towards, and experiences of, Family Involvement in decision-making. Methods Semi-structured interviews were conducted with 30 cancer patients, 33 Family members, 10 oncology nurses and 11 oncologists. Framework analysis methods were used. Results Three main themes were uncovered: (i) how Family are involved in the decision-making process: specific behaviours of Family across 5 (extended) decision-making stages; (ii) attitudes towards Family Involvement in the decision-making process: balancing patient authority with the rights of the Family; and (iii) factors influencing Family Involvement: patient, Family, cultural, relationship, and decision. Conclusion This study highlighted many specific behaviours of Family throughout the decision-making process, the complex participant attitudes toward retaining patient authority whilst including the Family, and insight into influencing factors. These findings will inform a conceptual framework describing Family Involvement in decision-making. Practice implications Clinicians could ascertain participant preferences and remain open to the varying forms of Family Involvement in decision-making. Given the important role of Family in the decision-making process, Family inclusive consultation strategies are needed.
Debra L. Roter - One of the best experts on this subject based on the ideXlab platform.
-
patient s cognitive function and attitudes towards Family Involvement in cancer treatment decision making a patient Family caregiver dyadic analysis
Cancer Research and Treatment, 2017Co-Authors: Dong Wook Shin, Debra L. Roter, Jong Hyock Park, Juhee Cho, So Young Kim, Hyung Kook Yang, Hyun Woo Lee, Sunseog Kweon, Yune Sik Kang, Keeho ParkAbstract:Purpose Older patient populations commonly have cognitive impairment, which might impact decisional capacity. We examined patients and Family caregivers preferences for Family Involvement in treatment decision making assuming different level of cognitive impairment, and sought to explore the factors associated with the preferences and the degree to which patients and Family members agree on preferences. Materials and methods A total of 358 elderly cancer patient and caregiver dyads were recruited from the 11 cancer centers in Korea andwere asked to express their preferences forFamily Involvement in treatment decision making using hypothetical scenarios with three different levels of cognitive status (intact, mild impairment, and severe impairment). Results Both patients and Family caregivers preferred greater Family dominance in treatment decision makingwith the increasing the level of cognitive impairment (39.7%, 60.9%, and 86.6% for patients and 45.0%, 66.2%, and 89.7% for caregivers in each scenarios). Patient and Family caregiver concordance in decisional control preference was small for all three scenarios (weighted κ=0.32, κ=0.26, and κ=0.36, respectively). Higher patient education was associated with preference for patient dominance in treatment decision in conditions of both mild and severe cognitive impairment. The association of higher patient education and patient-caregiver preference concordance was positive with intact cognition, while it was negative with severe cognitive impairment. Conclusion Decision control preferences were affected by hypothesized cognitive status of the patients. Findings from our study would be helpful to develop effective strategy for optimizing Family Involvement in cancer treatment decision in the context of deteriorating cognitive function of the patients.
-
attitudes toward Family Involvement in cancer treatment decision making the perspectives of patients Family caregivers and their oncologists
Psycho-oncology, 2017Co-Authors: Debra L. Roter, Dong Wook Shin, Juhee Cho, So Young Kim, Hyung Kook Yang, Keeho Park, Hyung Jin Kim, Heeyoung ShinAbstract:Background To investigate how cancer patients, Family caregiver, and their treating oncologist view the risks and benefits of Family Involvement in cancer treatment decision making (TDM) or the degree to which these perceptions may differ. Patients and Methods A nationwide, multicenter survey was conducted with 134 oncologists and 725 of their patients and accompanying caregivers. Participant answered to modified Control Preferences Scale and investigator-developed questionnaire regarding Family Involvement in cancer TDM. Results Most participants (>90%) thought that Family should be involved in cancer TDM. When asked if the oncologist should allow Family Involvement if the patient did not want them involved, most patients and caregivers (>85%) thought they should. However, under this circumstance, only 56.0% of oncologists supported Family Involvement. Patients were significantly more likely to skew their responses toward patient rather than Family decisional control than were their caregivers (P < .003); oncologists were more likely to skew their responses toward patient rather than Family decisional control than caregivers (P < .001). Most respondents thought that Family Involvement is helpful and neither hamper patient autonomy nor complicate cancer TDM process. Oncologists were largely positive, but less so in these ratings than either patients or caregivers (P < .002). Conclusions Patients, Family caregivers, and, to a lesser degree, oncologists expect and valued Family Involvement in cancer TDM. These findings support a reconsideration of traditional models focused on protection of patient autonomy to a more contextualized form of relational autonomy, whereby the patient and Family caregivers can be seen as a unit for autonomous decision.
-
preferences for and experiences of Family Involvement in cancer treatment decision making patient caregiver dyads study
Psycho-oncology, 2013Co-Authors: Man-soo Yoon, Debra L. Roter, Sang Kyun Sohn, Dong Wook Shin, Jong Hyock ParkAbstract:Background Despite the important role that Family caregivers play in providing emotional and practical support to cancer patients, relatively little is known about the Family caregiver's role in treatment decision-making (TDM). We sought to investigate patients' and Family caregivers' preferences for and experiences of Family Involvement in TDM and factors associated with preference concordance. Method A national survey was performed with 990 patient–caregiver dyads (participation rate:76.2%). Questions examining preferences for and experiences of Family Involvement in TDM were administered independently to patients and Family caregivers. Concordance was calculated with weighted kappa. Logistic regression analyses were used to identify predictors of patients' and caregivers' preferences for Family Involvement in TDM and concordance between them. Results Few patients or Family caregivers expressed a preference for unilateral decision-making; however, there was considerable variation and poor agreement within dyads in regard to whether the patient or Family caregivers should take the lead in decision-making with input from the other (weighted kappa between respondents for TDM preferences and experiences = 0.10 and κ = 0.18, respectively). Greater TDM preference concordance was associated with higher patient education, whereas lower levels of concordance were evident for younger patients, less educated caregivers, adult child patient dyads (as opposed to a spouse–patient dyads) and problematic Family communication about cancer. Conclusions Most patients and Family caregivers valued and expected Family Involvement in TDM. However, there is little explicit agreement in regard to which party in the dyad should take decisional leadership and who should play a supporting role. Copyright © 2013 John Wiley & Sons, Ltd.
Keeho Park - One of the best experts on this subject based on the ideXlab platform.
-
patient s cognitive function and attitudes towards Family Involvement in cancer treatment decision making a patient Family caregiver dyadic analysis
Cancer Research and Treatment, 2017Co-Authors: Dong Wook Shin, Debra L. Roter, Jong Hyock Park, Juhee Cho, So Young Kim, Hyung Kook Yang, Hyun Woo Lee, Sunseog Kweon, Yune Sik Kang, Keeho ParkAbstract:Purpose Older patient populations commonly have cognitive impairment, which might impact decisional capacity. We examined patients and Family caregivers preferences for Family Involvement in treatment decision making assuming different level of cognitive impairment, and sought to explore the factors associated with the preferences and the degree to which patients and Family members agree on preferences. Materials and methods A total of 358 elderly cancer patient and caregiver dyads were recruited from the 11 cancer centers in Korea andwere asked to express their preferences forFamily Involvement in treatment decision making using hypothetical scenarios with three different levels of cognitive status (intact, mild impairment, and severe impairment). Results Both patients and Family caregivers preferred greater Family dominance in treatment decision makingwith the increasing the level of cognitive impairment (39.7%, 60.9%, and 86.6% for patients and 45.0%, 66.2%, and 89.7% for caregivers in each scenarios). Patient and Family caregiver concordance in decisional control preference was small for all three scenarios (weighted κ=0.32, κ=0.26, and κ=0.36, respectively). Higher patient education was associated with preference for patient dominance in treatment decision in conditions of both mild and severe cognitive impairment. The association of higher patient education and patient-caregiver preference concordance was positive with intact cognition, while it was negative with severe cognitive impairment. Conclusion Decision control preferences were affected by hypothesized cognitive status of the patients. Findings from our study would be helpful to develop effective strategy for optimizing Family Involvement in cancer treatment decision in the context of deteriorating cognitive function of the patients.
-
attitudes toward Family Involvement in cancer treatment decision making the perspectives of patients Family caregivers and their oncologists
Psycho-oncology, 2017Co-Authors: Debra L. Roter, Dong Wook Shin, Juhee Cho, So Young Kim, Hyung Kook Yang, Keeho Park, Hyung Jin Kim, Heeyoung ShinAbstract:Background To investigate how cancer patients, Family caregiver, and their treating oncologist view the risks and benefits of Family Involvement in cancer treatment decision making (TDM) or the degree to which these perceptions may differ. Patients and Methods A nationwide, multicenter survey was conducted with 134 oncologists and 725 of their patients and accompanying caregivers. Participant answered to modified Control Preferences Scale and investigator-developed questionnaire regarding Family Involvement in cancer TDM. Results Most participants (>90%) thought that Family should be involved in cancer TDM. When asked if the oncologist should allow Family Involvement if the patient did not want them involved, most patients and caregivers (>85%) thought they should. However, under this circumstance, only 56.0% of oncologists supported Family Involvement. Patients were significantly more likely to skew their responses toward patient rather than Family decisional control than were their caregivers (P < .003); oncologists were more likely to skew their responses toward patient rather than Family decisional control than caregivers (P < .001). Most respondents thought that Family Involvement is helpful and neither hamper patient autonomy nor complicate cancer TDM process. Oncologists were largely positive, but less so in these ratings than either patients or caregivers (P < .002). Conclusions Patients, Family caregivers, and, to a lesser degree, oncologists expect and valued Family Involvement in cancer TDM. These findings support a reconsideration of traditional models focused on protection of patient autonomy to a more contextualized form of relational autonomy, whereby the patient and Family caregivers can be seen as a unit for autonomous decision.
Juhee Cho - One of the best experts on this subject based on the ideXlab platform.
-
patient s cognitive function and attitudes towards Family Involvement in cancer treatment decision making a patient Family caregiver dyadic analysis
Cancer Research and Treatment, 2017Co-Authors: Dong Wook Shin, Debra L. Roter, Jong Hyock Park, Juhee Cho, So Young Kim, Hyung Kook Yang, Hyun Woo Lee, Sunseog Kweon, Yune Sik Kang, Keeho ParkAbstract:Purpose Older patient populations commonly have cognitive impairment, which might impact decisional capacity. We examined patients and Family caregivers preferences for Family Involvement in treatment decision making assuming different level of cognitive impairment, and sought to explore the factors associated with the preferences and the degree to which patients and Family members agree on preferences. Materials and methods A total of 358 elderly cancer patient and caregiver dyads were recruited from the 11 cancer centers in Korea andwere asked to express their preferences forFamily Involvement in treatment decision making using hypothetical scenarios with three different levels of cognitive status (intact, mild impairment, and severe impairment). Results Both patients and Family caregivers preferred greater Family dominance in treatment decision makingwith the increasing the level of cognitive impairment (39.7%, 60.9%, and 86.6% for patients and 45.0%, 66.2%, and 89.7% for caregivers in each scenarios). Patient and Family caregiver concordance in decisional control preference was small for all three scenarios (weighted κ=0.32, κ=0.26, and κ=0.36, respectively). Higher patient education was associated with preference for patient dominance in treatment decision in conditions of both mild and severe cognitive impairment. The association of higher patient education and patient-caregiver preference concordance was positive with intact cognition, while it was negative with severe cognitive impairment. Conclusion Decision control preferences were affected by hypothesized cognitive status of the patients. Findings from our study would be helpful to develop effective strategy for optimizing Family Involvement in cancer treatment decision in the context of deteriorating cognitive function of the patients.
-
attitudes toward Family Involvement in cancer treatment decision making the perspectives of patients Family caregivers and their oncologists
Psycho-oncology, 2017Co-Authors: Debra L. Roter, Dong Wook Shin, Juhee Cho, So Young Kim, Hyung Kook Yang, Keeho Park, Hyung Jin Kim, Heeyoung ShinAbstract:Background To investigate how cancer patients, Family caregiver, and their treating oncologist view the risks and benefits of Family Involvement in cancer treatment decision making (TDM) or the degree to which these perceptions may differ. Patients and Methods A nationwide, multicenter survey was conducted with 134 oncologists and 725 of their patients and accompanying caregivers. Participant answered to modified Control Preferences Scale and investigator-developed questionnaire regarding Family Involvement in cancer TDM. Results Most participants (>90%) thought that Family should be involved in cancer TDM. When asked if the oncologist should allow Family Involvement if the patient did not want them involved, most patients and caregivers (>85%) thought they should. However, under this circumstance, only 56.0% of oncologists supported Family Involvement. Patients were significantly more likely to skew their responses toward patient rather than Family decisional control than were their caregivers (P < .003); oncologists were more likely to skew their responses toward patient rather than Family decisional control than caregivers (P < .001). Most respondents thought that Family Involvement is helpful and neither hamper patient autonomy nor complicate cancer TDM process. Oncologists were largely positive, but less so in these ratings than either patients or caregivers (P < .002). Conclusions Patients, Family caregivers, and, to a lesser degree, oncologists expect and valued Family Involvement in cancer TDM. These findings support a reconsideration of traditional models focused on protection of patient autonomy to a more contextualized form of relational autonomy, whereby the patient and Family caregivers can be seen as a unit for autonomous decision.
