Medical Decision-Making Incapacity among Newly Diagnosed Older Patients with Hematological Malignancy Receiving First Line Chemotherapy: A Cross-Sectional Study of Patients and Physicians
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{"title"=>"Medical decision-making incapacity among newly diagnosed older patients with hematological malignancy receiving first line chemotherapy: A cross-sectional study of patients and physicians", "type"=>"journal", "authors"=>[{"first_name"=>"Koji", "last_name"=>"Sugano", "scopus_author_id"=>"56583660400"}, {"first_name"=>"Toru", "last_name"=>"Okuyama", "scopus_author_id"=>"34572640400"}, {"first_name"=>"Shinsuke", "last_name"=>"Iida", "scopus_author_id"=>"7401432738"}, {"first_name"=>"Hirokazu", "last_name"=>"Komatsu", "scopus_author_id"=>"7202894056"}, {"first_name"=>"Takashi", "last_name"=>"Ishida", "scopus_author_id"=>"8595030800"}, {"first_name"=>"Shigeru", "last_name"=>"Kusumoto", "scopus_author_id"=>"7102741325"}, {"first_name"=>"Megumi", "last_name"=>"Uchida", "scopus_author_id"=>"14323813600"}, {"first_name"=>"Tomohiro", "last_name"=>"Nakaguchi", "scopus_author_id"=>"36630742300"}, {"first_name"=>"Yosuke", "last_name"=>"Kubota", "scopus_author_id"=>"55509993300"}, {"first_name"=>"Yoshinori", "last_name"=>"Ito", "scopus_author_id"=>"55672492200"}, {"first_name"=>"Kazuhisa", "last_name"=>"Takahashi", "scopus_author_id"=>"55505396300"}, {"first_name"=>"Tatsuo", "last_name"=>"Akechi", "scopus_author_id"=>"7005796178"}], "year"=>2015, "source"=>"PLoS ONE", "identifiers"=>{"issn"=>"19326203", "scopus"=>"2-s2.0-84942887889", "pui"=>"606195626", "doi"=>"10.1371/journal.pone.0136163", "isbn"=>"1932-6203", "sgr"=>"84942887889", "pmid"=>"26296202"}, "id"=>"487f9cc9-4638-3ca2-a7c0-4f03efc3fc02", "abstract"=>"BACKGROUND: Decision-making capacity to provide informed consent regarding treatment is essential among cancer patients. The purpose of this study was to identify the frequency of decision-making incapacity among newly diagnosed older patients with hematological malignancy receiving first-line chemotherapy, to examine factors associated with incapacity and assess physicians' perceptions of patients' decision-making incapacity. METHODS: Consecutive patients aged 65 years or over with a primary diagnosis of malignant lymphoma or multiple myeloma were recruited. Decision-making capacity was assessed using the Structured Interview for Competency and Incompetency Assessment Testing and Ranking Inventory-Revised (SICIATRI-R). Cognitive impairment, depressive condition and other possible associated factors were also evaluated. RESULTS: Among 139 eligible patients registered for this study, 114 completed the survey. Of these, 28 (25%, 95% confidence interval [CI]: 17%-32%) were judged as having some extent of decision-making incompetency according to SICIATRI-R. Higher levels of cognitive impairment and increasing age were significantly associated with decision-making incapacity. Physicians experienced difficulty performing competency assessment (Cohen's kappa -0.54). CONCLUSIONS: Decision-making incapacity was found to be a common and under-recognized problem in older patients with cancer. Age and assessment of cognitive impairment may provide the opportunity to find patients that are at a high risk of showing decision-making incapacity.", "link"=>"http://www.mendeley.com/research/medical-decisionmaking-incapacity-among-newly-diagnosed-older-patients-hematological-malignancy-rece", "reader_count"=>31, "reader_count_by_academic_status"=>{"Researcher"=>5, "Student > Ph. D. Student"=>3, "Student > Postgraduate"=>1, "Student > Master"=>8, "Other"=>1, "Student > Bachelor"=>6, "Professor"=>1, "Unspecified"=>6}, "reader_count_by_user_role"=>{"Researcher"=>5, "Student > Ph. D. Student"=>3, "Student > Postgraduate"=>1, "Student > Master"=>8, "Other"=>1, "Student > Bachelor"=>6, "Professor"=>1, "Unspecified"=>6}, "reader_count_by_subject_area"=>{"Unspecified"=>8, "Nursing and Health Professions"=>1, "Medicine and Dentistry"=>13, "Agricultural and Biological Sciences"=>1, "Neuroscience"=>1, "Psychology"=>6, "Chemistry"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>13}, "Neuroscience"=>{"Neuroscience"=>1}, "Chemistry"=>{"Chemistry"=>1}, "Psychology"=>{"Psychology"=>6}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>1}, "Unspecified"=>{"Unspecified"=>8}}, "reader_count_by_country"=>{"United Kingdom"=>2}, "group_count"=>2}

Scopus | Further Information

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Figshare

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Relative Metric

{"start_date"=>"2015-01-01T00:00:00Z", "end_date"=>"2015-12-31T00:00:00Z", "subject_areas"=>[]}
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