Preferred and actual participation roles in operation treatment decision making of patients with colorectal cancer

Purpose:To investigate the preferred and actual participation levels of colorectal cancer patients and their families in treatment decision-making.Methods:A cross-sectional survey was conducted using a questionnaire administered to colorectal cancer patients hospitalized in the general surgical wards in two of the upper first-class hospitals in Beijing between February and July 2013.Results:A total of 113 questionnaires were analyzed.For the families of colorectal cancer patients,the concordance rate of their preferred and actual participation levels in treatment decision-making was 60.2%and 62.8%for the patients themselves.Patients with stoma and male patients preferred a passive role compared to those without stoma and female patients(χ^(2)=7.978,p<0.05;χ^(2)=9.854,p<0.05).Conclusions:Over 40%of colorectal cancer patients preferred a passive role in treatment decision-making.We suggest that communication between physicians and patients should be strengthened to accommodate the patient's desired level of involvement.

Experiencing Participation in Health Care: “Through the Eyes of Older Adults”

Background: Patient participation is well understood by health care professionals but not many studies have focused on the older adults and their perceptions of patient participation. Aim and Objectives: To report an analysis of the concept of participation from the perspective of the older adult. Design: Concept analysis. Methods: An integrative review approach was undertaken and the searches were limited from January 2003 to December 2014, guiding question was;“what constitutes patient participation according to the older adult?” Results: Through the eyes of the older adults, a two-way communication should be initiated by the staff. Equality and sharing power between older adults and staffs was perceived as a precondition. Been given time was an essential issue, implying that older adults wished to have enough time from staffs and be in the right context surrounded by the appropriate environment in order to experience participation. Conclusion: In order to experience participation for older adults, it is important that the health care professionals are aware of how and in what ways they can contribute to participation among older adults. The need or wish to create participation is not enough;the health care professional needs to see and understand participation through the older adult’s eyes. Thus, a person-centered nursing approach is relevant for the health care professional in order to both give and maintain the experience of participation to the older adult.

Acceptance on colorectal cancer screening upper age limit in South Korea

BACKGROUND The Korea National Cancer Screening Program currently provides screening for colorectal cancer(CRC)for adults older than 50 years with no upper age limit.In general,people are likely to only pay attention to the benefits of cancer screening and to neglect its risks.Most consider the benefits of cancer screening as being far greater than the risks and are unaware that any potential benefits and harms can vary with age.AIM To report acceptance of an upper age limit for CRC screening and factors associated therewith among cancer-free individuals in Korea.METHODS The present study analyzed data from the Korea National Cancer Screening Survey 2017,a nationally representative random sample of 4500 Korean individuals targeted for screening for the five most common types of cancer.A total of 1922 participants were included in the final analysis.The baseline characteristics of the study population are presented as unweighted numbers and weighted proportions.Both univariate and multivariate logistic regression models were developed to examine factors related with acceptance of an upper age limit for CRC screening;subgroup analysis was also applied.RESULTS About 80%(1554/1922)of the respondents agreed that CRC screening should not be offered for individuals older than 80 years.Specifically,those who had never been screened for CRC had the highest acceptance rate(91%).Overall,screening history for CRC[screened by both fecal occult blood test and colonoscopy,adjusted odds ratio(aOR)=0.33,95%CI:0.22-0.50]and other cancers(aOR=0.55,95%CI:0.34-0.87),as well as a family history of cancer(aOR=0.66,95%CI:0.50-0.87),were negatively associated with acceptance of an upper age limit for CRC screening.In contrast,metropolitan residents(aOR=1.86,95%CI:1.29-2.68)and people who exercised regularly(aOR=1.42,95%CI:1.07-1.89)were more likely to accept an upper age limit.After subgrouping,we found gender,marital status,and lifetime smoking history among never-screened individuals and residential region,family history of cancer,and physical activity among never-screened individuals to be associated with acceptance of an upper age limit.CONCLUSION This study describes acceptance of an upper age limit for CRC screening and factors associated with it,and provides perspectives that should be considered,in addition to scientific evidence,when developing population-based cancer screening policies and programs.

The difficulty of medical decision-making:should patients be involved?

Introduction The success or failure of treatment has long been attributed to the doctors alone,but the role of patients in the medical decision-making(MDM)process has often been ignored.As medical development and health needs increase,the desire of patients to participate in MDM continues to grow.This raises the question:should patients be involved in such a highly professional medical activity?How can their involvement bring better clinical benefits?