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Tailoring Reports for Patient-Reported Health Information Within Digital Health Tools: Impacts on the Quality of Values Elicitation and Clarification for Complex Treatment Decision-Making in Older Adults with Advanced Cancers
Tailoring Reports for Patient-Reported Health Information Within Digital Health Tools: Impacts on the Quality of Values Elicitation and Clarification for Complex Treatment Decision-Making in Older Adults with Advanced Cancers
상세정보
- 자료유형
- 학위논문 서양
- 최종처리일시
- 20260202102954
- ISBN
- 9798315714804
- DDC
- 616.99
- 저자명
- Cole, Amy C.
- 서명/저자
- Tailoring Reports for Patient-Reported Health Information Within Digital Health Tools: Impacts on the Quality of Values Elicitation and Clarification for Complex Treatment Decision-Making in Older Adults with Advanced Cancers
- 발행사항
- [Sl] : The University of North Carolina at Chapel Hill, 2025
- 발행사항
- Ann Arbor : ProQuest Dissertations & Theses, 2025
- 형태사항
- 254 p
- 주기사항
- Source: Dissertations Abstracts International, Volume: 86-11, Section: B.
- 주기사항
- Advisor: Mazur, Lukasz.
- 학위논문주기
- Thesis (Ph.D.)--The University of North Carolina at Chapel Hill, 2025.
- 초록/해제
- 요약For older adults (≥60) with advanced cancer, treatment decisions may vary substantially from those diagnosed at an earlier stage. Often these patients feel their values and concerns are not incorporated in treatment decisions. Effective methods are needed to elicit, discuss and incorporate patient values into treatment decisions. Best-worst scaling (BWS) is a theory driven approach used in healthcare to elicit values. Tailoring health information, including question prompt lists, can encourage patients to actively participate in consultations. This dissertation addresses a research gap in understanding how tailoring summary reports based on patients' values elicited from a BWS instrument can prepare and encourage patients to discuss their values and engage in shared decision-making (SDM). This dissertation was conducted in four stages; engagement, development, pretesting, and pilot testing of a values-clarification tool called VOICE. During engagement and development, key stakeholders engaged in concept mapping activities, resulting in consensus on 7 treatment values and 2-3 question prompts per value that are important to older adults with advanced cancer. This aim emphasized participatory engagement among diverse stakeholders and incorporation of tailoring techniques to ensure VOICE was relevant to the intended patient population. During pretesting, participants perceived VOICE to be effective, acceptable, and useful for preparing older adults with advanced cancer to engage in values-based discussions with their clinicians. Patients' desire to assess, reassess and discuss their values must be incorporated into consultations, and patients want to work with their clinician to align their care with what matters most to them as an individual. During pilot testing, VOICE was found to be more useful in preparing patients to discuss their values than an American Cancer Society flyer, and patients had a clear preference for values-based discussions. This dissertation provided evidence that VOICE resulted in higher quality values-based discussions while highlighting the need for values-clarification training for medical students and oncologists. This dissertation advances knowledge regarding values-clarification, yet further research is still needed to better understand the influencers and contextual factors that provide facilitation or barriers to improving engagement between patients and clinicians and ensures patients values are discussed, understood, and incorporated into treatment decisions.
- 일반주제명
- Oncology
- 일반주제명
- Gerontology
- 일반주제명
- Biostatistics
- 일반주제명
- Aging
- 키워드
- Human factors
- 기타저자
- The University of North Carolina at Chapel Hill Health Informatics
- 기본자료저록
- Dissertations Abstracts International. 86-11B.
- 전자적 위치 및 접속
- 로그인 후 원문을 볼 수 있습니다.
MARC
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■006m o d
■007cr#unu||||||||
■020 ▼a9798315714804
■035 ▼a(MiAaPQ)AAI31768562
■040 ▼aMiAaPQ▼cMiAaPQ
■0820 ▼a616.99
■1001 ▼aCole, Amy C.
■24510▼aTailoring Reports for Patient-Reported Health Information Within Digital Health Tools: Impacts on the Quality of Values Elicitation and Clarification for Complex Treatment Decision-Making in Older Adults with Advanced Cancers
■260 ▼a[Sl]▼bThe University of North Carolina at Chapel Hill▼c2025
■260 1▼aAnn Arbor▼bProQuest Dissertations & Theses▼c2025
■300 ▼a254 p
■500 ▼aSource: Dissertations Abstracts International, Volume: 86-11, Section: B.
■500 ▼aAdvisor: Mazur, Lukasz.
■5021 ▼aThesis (Ph.D.)--The University of North Carolina at Chapel Hill, 2025.
■520 ▼aFor older adults (≥60) with advanced cancer, treatment decisions may vary substantially from those diagnosed at an earlier stage. Often these patients feel their values and concerns are not incorporated in treatment decisions. Effective methods are needed to elicit, discuss and incorporate patient values into treatment decisions. Best-worst scaling (BWS) is a theory driven approach used in healthcare to elicit values. Tailoring health information, including question prompt lists, can encourage patients to actively participate in consultations. This dissertation addresses a research gap in understanding how tailoring summary reports based on patients' values elicited from a BWS instrument can prepare and encourage patients to discuss their values and engage in shared decision-making (SDM). This dissertation was conducted in four stages; engagement, development, pretesting, and pilot testing of a values-clarification tool called VOICE. During engagement and development, key stakeholders engaged in concept mapping activities, resulting in consensus on 7 treatment values and 2-3 question prompts per value that are important to older adults with advanced cancer. This aim emphasized participatory engagement among diverse stakeholders and incorporation of tailoring techniques to ensure VOICE was relevant to the intended patient population. During pretesting, participants perceived VOICE to be effective, acceptable, and useful for preparing older adults with advanced cancer to engage in values-based discussions with their clinicians. Patients' desire to assess, reassess and discuss their values must be incorporated into consultations, and patients want to work with their clinician to align their care with what matters most to them as an individual. During pilot testing, VOICE was found to be more useful in preparing patients to discuss their values than an American Cancer Society flyer, and patients had a clear preference for values-based discussions. This dissertation provided evidence that VOICE resulted in higher quality values-based discussions while highlighting the need for values-clarification training for medical students and oncologists. This dissertation advances knowledge regarding values-clarification, yet further research is still needed to better understand the influencers and contextual factors that provide facilitation or barriers to improving engagement between patients and clinicians and ensures patients values are discussed, understood, and incorporated into treatment decisions.
■590 ▼aSchool code: 0153.
■650 4▼aOncology
■650 4▼aGerontology
■650 4▼aBiostatistics
■650 4▼aAging
■653 ▼aDecision support tools
■653 ▼aHuman factors
■653 ▼aPatient-clinician communication
■653 ▼aShared decision-making
■653 ▼aTailoring health information
■653 ▼aValues-clarification
■690 ▼a0992
■690 ▼a0351
■690 ▼a0308
■690 ▼a0493
■71020▼aThe University of North Carolina at Chapel Hill▼bHealth Informatics.
■7730 ▼tDissertations Abstracts International▼g86-11B.
■790 ▼a0153
■791 ▼aPh.D.
■792 ▼a2025
■793 ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17356571▼nKERIS▼z이 자료의 원문은 한국교육학술정보원에서 제공합니다.
