Chest
Ethics in Cardiopulmonary MedicineIntubation and Mechanical Ventilation for COPD: Development of an Instrument To Elicit Patient Preferences
Section snippets
Development of the MV Information Scenario
Fifteen respirologists from the Ottawa area were interviewed to determine the type of information exchanged between physicians and their patients about the prognosis of COPD, the ventilation process, and possible outcomes of MV.24 The interviews were tape-recorded and transcribed, and content analysis of the qualitative data was performed2526 to identify themes that were then incorporated into the decision aid. The information was reviewed for completeness and accuracy by members of the
Results
Twenty of 21 consecutive patients who were approached agreed to participate in the study; only 1 patient refused to complete the entire interview process. One patient did not want to commit to the time and energy required for the interview. All the patients were cared for by six specialists, with no one physician accountable for > 30% of these patients. The average length of the interviews was 79 min (range, 50 to 138 min). The patients were equally divided by gender (10 men, 10 women), had an
Discussion
In summary, we developed and applied an information scenario and a probability trade-off technique. Together, these elements constituted a proposed decision aid designed to provide information, describe choices, and allow patients with severe COPD to express the strength of their convictions concerning MV. We attempted to evaluate this decision aid from three different perspectives. Below, we first discuss this study in terms of its original motivation, and then we examine the extent to which
COPD (Emphysema)
COPD stands for chronic obstructive pulmonary disease. It is often called emphysema or chronic bronchitis, and it is a common disease that affects the lungs. When a patient has COPD or emphysema, the air passages in the lungs become narrow. This makes it difficult to get air in and out, like breathing through a straw.
Even though the patient does not feel sick, he or she might have trouble breathing and become short of breath very easily.
How Does COPD Affect Daily Life?
COPD affects the way a person performs his or her daily
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2023, Social Science and MedicineA systematic review of effectiveness of decision aids to assist older patients at the end of life
2017, Patient Education and CounselingCitation Excerpt :Generic expression of preferences used 5-point ranking scales from “very likely to make this decision” or “already made the decision” or “definitely want the treatment” to “very unlikely to make or communicate the decision” and “definitely do not want that treatment”[18]. The more specific descriptors included examples such as hospital transfer [21], invasive mechanical ventilation [28], CPR and artificial nutrition or intravenous hydration. [18,19,21] The benefits of treatment options were more frequently included (8 studies) in descriptive form including an Expectation of Benefit Index[29] rather than in terms of risk probability, and some were limited to perceived rather than actual benefits [30].
Key stakeholders' perspectives on a Web-based advance care planning tool for advanced lung disease
2015, Journal of Critical CareCitation Excerpt :Motivation has been shown to be a key factor in promoting health behavior change [29] and is an important part of any advance care planning intervention [30]. Second, existing decision aids for lung disease focus solely on patients' decision about mechanical ventilation [31,32]. Our data indicate that users desire more from advance care planning.
Quantitative patient preference evidence for health technology assessment: A case study
2013, International Journal of Technology Assessment in Health Care
Drs. Hebert and O'Connor are Career Scientists of the Ontario Minister Of Health. Dr. Llewellyn-Thomas is a National Health Research Scholarsupported by the National Health Research and Development Program.
This research was funded in part by the Ontario Thoracic Society.