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251. Introduction

Author

Youngner, Stuart J., primary, Siminoff, Laura A., additional, and Schapiro, Renie, additional

Published
2004
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258. Conducting Empirical Research on Informed Consent: Challenges and Questions

Author

Sachs, Greg A., primary, Hougham, Gavin W., additional, Sugarman, Jeremy, additional, Agre, Patricia, additional, Broome, Marion E., additional, Geller, Gail, additional, Kass, Nancy, additional, Kodish, Eric, additional, Mintz, Jim, additional, Roberts, Laura W., additional, Sankar, Pamela, additional, Siminoff, Laura A., additional, Sorenson, James, additional, and Weiss, Anita, additional

Published
2003
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259. Validation of a Decision Regret Scale

Author

Brehaut, Jamie C., primary, O'Connor, Annette M., additional, Wood, Timothy J., additional, Hack, Thomas F., additional, Siminoff, Laura, additional, Gordon, Elisa, additional, and Feldman-Stewart, Deb, additional

Published
2003
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262. Organ donation in the United States

Author

Nathan, Howard M., primary, Conrad, Suzanne L., additional, Held, Philip J., additional, McCullough, Keith P., additional, Pietroski, Richard E., additional, Siminoff, Laura A., additional, and Ojo, Akinlolu O., additional

Published
2003
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264. Decision Regret Scale

Author

Brehaut, Jamie C., primary, O’Connor, Annette M., additional, Wood, Timothy J., additional, Hack, Thomas F., additional, Siminoff, Laura, additional, Gordon, Elisa, additional, and Feldman-Stewart, Deb, additional

Published
2003
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268. The nondirected live-kidney donor: ethical considerations and practice guidelines

Author

Adams, Patricia L., primary, Cohen, David J., additional, Danovitch, Gabriel M., additional, Edington, Reverend Mark D., additional, Gaston, Robert S., additional, Jacobs, Cheryl L., additional, Luskin, Richard S., additional, Metzger, Robert A., additional, Peters, Thomas G., additional, Siminoff, Laura A., additional, Veatch, Robert M., additional, Rothberg-Wegman, Lynn, additional, Bartlett, Stephen T., additional, Brigham, Lori, additional, Burdick, James, additional, Gunderson, Susan, additional, Harmon, William, additional, Matas, Arthur J., additional, Thistlethwaite, J. Richard, additional, and Delmonico, Francis L., additional

Published
2002
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280. The OPTNDeceased Donor Potential Study: Implications for Policy and Practice

Author

Klassen, D. K., Edwards, L. B., Stewart, D. E., Glazier, A. K., Orlowski, J. P., Berg, C. L., McCleary, Karl J, Hirsch, Gary B, Boulware, L. Ebony, King, Gary, Myer, Kevin A, Reibel, Michael, Rosendale, John D, Saeed, Khalid, Siminoff, Laura A, Soret, Samuel, Wagstaff, David A, Wile, Kristina, Essien, Joyce D K, Crandall, Betty C, Cornell, Danielle L, Jacobs, David G, Bosch, David W, Howard, David H, Faulkner, Dorothy L, Bergstrom, George F, Rushton, Gerald, Franklin, Glen, Wilkins, Harry E, Rahmandad, Hazhir, Nathan, Howard M, Tuttle‐Newhall, J Elizabeth, Wynn, James J, Whaley, Janice, Perryman, Jennie P, Schold, Jesse, Belcher, John, Mayglothing, Julie A, Garcia, Karen, O'Conner, Kevin J, Kyckholm, Laurie J, Ohler, Linda, Markham, Lori E, Sastry, M Anjali, Farinelli Fierro, Marcella, DeLauro, Maria, Kelleher‐Crabtree, Mary, Johnson, Maryl R, Rogers, Meg M, Pyrsopoulos, Nikolaos T, Geraghty, P J, Halverson, Paul K, Bennett, Renee, Hasz, Richard D, Higgins, Robert S D, Youngner, Stuart J, Conrad, Suzanne Lane, Mone, Thomas, Nakagawa, Thomas A, Bleck, Thomas P, Pruett, Timothy L, Durbin, Richard, McLaughlin, Christopher J, Belgay, Teresa M, and Shepard, Brian

Abstract

The Organ Procurement and Transplantation Network (OPTN) Deceased Donor Potential Study, funded by the Health Resources and Services Administration, characterized the current pool of potential deceased donors and estimated changes through 2020. The goal was to inform policy development and suggest practice changes designed to increase the number of donors and organ transplants. Donor estimates used filtering methodologies applied to datasets from the OPTN, the National Center for Health Statistics, and the Agency for Healthcare Research and Quality and used these estimates with the number of actual donors to estimate the potential donor pool through 2020. Projected growth of the donor pool was 0.5% per year through 2020. Potential donor estimates suggested unrealized donor potential across all demographic groups, with the most significant unrealized potential (70%) in the 50–75‐year‐old age group and potential Donation after Circulatory Death (DCD) donors. Actual transplants that may be realized from potential donors in these categories are constrained by confounding medical comorbidities not identified in administrative databases and by limiting utilization practices for organs from DCDdonors. Policy, regulatory, and practice changes encouraging organ procurement and transplantation of a broader population of potential donors may be required to increase transplant numbers in the United States. Findings from the OPTN Deceased Donor Potential Study suggest possible transplant center and organ procurement organization practice changes, as well as potential transplant system regulatory changes, which may expand the donor pool.

Published
2016
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287. Factors associated with delayed patient appraisal of colorectal cancer symptoms.

Author

Siminoff, Laura, Thomson, Maria, and Dumenci, Levent

Subjects
*COLON cancer patients, *COGNITIVE analysis, *MEDICAL records, *BIVARIATE analysis, *STRUCTURAL equation modeling
Abstract

Objective: To evaluate the relationship between symptoms, financial and cognitive barriers with patient delays in seeking evaluation of symptoms. Methods: Data were collected from 252 colorectal cancer patients from academic and community oncology practices in Virginia and Ohio. We used a cross-sectional, mixed methods design collected data through patient interviews and medical record reviews. Structural equation modeling (SEM) tested the hypothesized relationships between symptoms, financial and cognitive barriers and patient care seeking delays. Results: In bivariate analyses, patients who reported a financial barrier to accessing health care (t (246)?=?-2.6, p?

Published
2014
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288. Assessing patient-caregiver communication in cancer--a psychometric validation of the Cancer Communication Assessment Tool (CCAT-PF) in a German sample.

Author

Haun, Markus W, Sklenarova, Halina, Winkler, Eva C, Huber, Johannes, Thomas, Michael, Siminoff, Laura A, Woll, Michael, Brechtel, Anette, Herzog, Wolfgang, and Hartmann, Mechthild

Abstract

Purpose: The recently introduced Cancer Communication Assessment Tool (CCAT-PF) measures congruence in patient-caregiver communication and was initially validated in lung cancer patients. Contributing to a greater proportion of the variance in the conflict scores, primary caregivers were hypothesized to experience greater stress. For a detailed understanding of conflicting communication patterns of cancer-affected families, our study aimed for psychometric validation of the CCAT-PF in a sample covering heterogeneous tumor entities.Methods: Subsequent to a cross-sectional survey of 189 pairs of cancer patients (31 % gastrointestinal, 34 % lung, and 35 % urological) and their caregivers' exploratory factor analysis with principal component condensation and varimax rotation was conducted (response rate, 74.2 %). Reliability and construct validity were assessed calculating Cronbach's α and Pearson correlation coefficients for CCAT-P and CCAT-F scales and related constructs, respectively.Results: Cancer-related communication according to the CCAT-PF can be subdivided into four factors including the scales Disclosure, Limitation of treatment, Family involvement in treatment decisions, and Continuing treatment. Reliability ranged from α = .51-.68. The Disclosure scale, describing poor cancer-related communication of the patient, was correlated with patient's distress (QSC-R10: r = .30, p < .0001), unmet needs in several areas (SCNS-SF-34: r = .25-.32, p < .001), and negatively with social/family well-being (FACT: r = -0.31, p < .0001). Higher scores on the scale were significantly associated with considerable decrements in emotional well-being especially for caregivers perceiving patients' disclosure as problematic.Conclusions: The Disclosure scale originating from the CCAT-PF emerged as a short, valid, and reliable stand-alone instrument for identifying conflicting communication in patient-caregiver-dyads at risk. [ABSTRACT FROM AUTHOR]

Published
2014
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289. Cancer Patients' Understanding of Prognostic Information.

Author

Cartwright, Laura, Dumenci, Levent, Siminoff, Laura, and Matsuyama, Robin

Abstract

Prognostic information is necessary for cancer patients to be fully informed about the likely course of their disease. This information is needed for practical planning and treatment decisions. This study sought to examine how cancer patients understand the prognosis information available to them. The setting is an urban safety net hospital. Six focus groups with cancer patients ( N = 39) were digitally recorded and transcribed verbatim then analyzed using phases of content analysis. Participants in all groups discussed the prognosis almost exclusively in terms of mortality and reported that their physicians and nurses mostly provided prognostic information in terms of months or years for survival. This finding held across all cancer types and stages. Patients tend to think of prognosis information as being only estimated limited survival and find the idea upsetting. Due to this view on prognosis, patients need further explanation regarding where the prognosis information comes from and what prognostic information can tell them in order to make use of it. [ABSTRACT FROM AUTHOR]

Published
2014
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293. Differences in Oncologist Communication Across Age Groups and Contributions to Adjuvant Decision Outcomes

Author

Step, Mary M., Siminoff, Laura A., and Rose, Julia H.

Subjects
Women -- Health aspects, Cancer -- Research, Aged, Physician and patient, Oncology, Experimental, Health, Seniors
Abstract

To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1532-5415.2009.02512.x Byline: Mary M. Step (*), Laura A. Siminoff ([dagger]), Julia H. Rose (*[double dagger]s.[parallel]) Keywords: breast cancer; physician-patient communication; decision-making; communication accommodation Abstract: The objective of this study was to assess potential age-related differences in oncologist communication during conversations about adjuvant therapy decisions and subsequent patient decision outcomes. Communication was observed between a cross-section of female patients aged 40 to 80 with early-stage breast cancer (n=180) and their oncologists (n=36) in 14 academic and community oncology practices in two states. Sources of data included audio recordings of visits, followed by post-visit patient interviews. Communication during the visit was assessed using the Siminoff Communication Content and Affect Program. Patient outcome measures included self-reported satisfaction with decision, decision conflict, and decision regret. Results showed that oncologists were significantly more fluent and more direct with older than middle-aged patients and trended toward expressing their own treatment preferences more with older patients. Satisfaction with treatment decisions was highest for women in their 50s and 60s. Decision conflict was significantly associated with more discussion of oncologist treatment preferences and prognosis. Decision regret was significantly associated with patient age and education. Older adults considering adjuvant therapy may find that oncologists' communication accommodations to perceived deficiencies in older adult cognition or communication challenge their decision-making involvement. Oncologists should carefully assess patient decision-making preferences and be mindful of accommodating their speech to age-related stereotypes. Author Affiliation: (From the) (*)Departments of Family Medicine ([dagger])Department of Social and Behavioral Health, Virginia Commonwealth University, Richmond, Virginia ([double dagger])Geriatrics and Palliative Care (s.)Bioethics, and ([parallel])Biostatistics and Epidemiology, School of Medicine, Case Western Reserve University, Cleveland, Ohio. Article note: Address correspondence to Mary M. Step, Department of Family Medicine, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106. E-mail: mms8@case.edu

Published
2009

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