Health decision making and cancer

Question 1

What are the 4 questions to ask when in a health decision scenarios?

Answer 1

1. feeling sure
2. know the benefits
3. which benefits and risks matter the most
4. have enough support

Question 2

What is client centered care?

Answer 2

providing care that is respectful of and responsive to individual patient preferences, needs and values

Question 3

What are the implications of decision making?

Answer 3

• resource access/ planning
• family health
• quality of life
• financial
• symptom management

Question 4

What is a nurses role in client centered care?

Answer 4

• involved clients in decision making
• provide structured decision support using patient decision aids and decision coaching

Question 5

What are the treatments related to CKD?

Answer 5

• renal replacement modality
• renal transplant
• vascular access

Question 5

What is the advance care planning and lifestyle changes for people with CKD?

Answer 5

withholding/ withdrawing dialysis
- scheduling of treatments
- adherence to care plans
- preferred participation in self care
- place of treatment

Question 6

Decisional conflict - What are some innate contributing factors of decision making?

Answer 6

• 2 or more outcomes
  outcomes: risky/ uncertain

value tradeoff: benefits versus harms

anticipated regrets: missed benefits from not choosing option

Question 7

What are the modifiable contributing factors?

Answer 7

• knowledge and expectation
• values clarity
• support and resources

Question 8

What is the biggest consequence of decisional conflict?

Answer 8

most of the time people are likely to change their mind (59 times)

Question 9

What are the 3 parts of the ottawa decision support framework?

Answer 9

• decisional needs
• decision quality
• decision support

Question 9

How are patient decision plans better that the standard care?

Answer 9

• improved decision quality
• reduced decisional conflict helps undecided to decide
• patients are 40% less passive in decisions

Question 10

what are the challenges to implementation?

Answer 10

• mismatch and lack of incentives
• disruption to establish workflows
• lack of confidence

Question 10

what is the leading cause of death in Canada and what are the 5 year survival rates?

Answer 10

cancer
- lung (22)
- breast (89)

Question 11

What are the three classes of cancers?

Answer 11

carcinomas: epithelial tissue (ex. breast, intestines)
sarcomas: middle layer tissues (ex. bone, muscle)
lymphomas: lymphatic system (ex. leukemia)

Question 11

What are some types of cancers?

Answer 11

• lung
• breast
• colo-rectal
• prostate
• skin
• testicular
• ovarian
• hematologic
• oral