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Published on: September 27, 2019
Fit and misfit
Margaret H Crighton1, Jennifer H Lingler, Mary Beth Happ
1Department of acute and Tertiary Care, Department of Health and Community System, University of Pittsburg School of Nursing, Pittsburg, PA 15261, USA. mhapp@pitt.edu
This study examines an older adult
Area of Science:
- Geriatric Oncology
- Behavioral Decision Theory
- Medical Decision Making
Background:
- Treatment decisions in acute myeloid leukemia (AML) are complex for older adults.
- Behavioral decision theory offers frameworks for understanding these choices.
- Geriatric oncology requires tailored decision-making support.
Purpose of the Study:
- To analyze an older adult's treatment decision-making process for AML.
- To evaluate the utility of behavioral decision theory constructs in geriatric oncology.
- To identify themes influencing treatment choices in advanced cancer.
Main Methods:
- Interpretive case analysis of interview and observational data.
- Comparison of case data with constructs from behavioral decision theory.
- Exploration of patient, clinician, and family member interplay.
Main Results:
- Behavioral decision theory constructs like trade-offs and certainty effect showed some utility.
- Patient preferences were often expressed through quality of life considerations, not direct treatment choices.
- The 'Cage' theme highlighted the dilemma of undesirable treatment options and aggressive therapy consequences.
Conclusions:
- Existing decision theory provides partial insight into geriatric oncology treatment choices.
- Quality of life preferences are crucial in older adults' treatment decisions.
- Further research is needed to develop practical theories for geriatric oncology decision support.
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