Decision Conflicts in Clinical Care during COVID-19: A Multi-Perspective Inquiry
Abstract
:1. Introduction
2. Materials and Methods
2.1. Questionnaire Development
2.2. Sample
2.3. Variables
2.4. Data Analysis
3. Results
3.1. Questionnaire Responses
3.2. Decisional Uncertainty and Conflicts
3.3. Consequences of Decisional Uncertainty and Conflicts
3.4. Reasons and Vulnerability
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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# Respondents | Female/Male a | Age b | Experience c | % Respond | |
---|---|---|---|---|---|
Oncology Physicians | 207 | 97/109 | 43.3 ± 10.3 | 15.2 ± 10.5 | 16.8 |
Oncology Nurses | 241 | 202/35 | 42.3 ± 12.3 | 19.1 ± 12.3 | 19.6 |
Oncology Patients | 386 | 197/183 | 59.7 ± 15.6 | 31.4 | |
Psychiatry Physicians | 115 | 63/51 | 38.5 ± 10.5 | 9.9 ± 9.2 | 9.3 |
Psychiatry Nurses | 128 | 85/33 | 43.4 ± 19.3 | 19.3 ± 12.6 | 10.4 |
Psychiatry Patients | 154 | 86/62 | 39.3 ± 15.6 | 12.5 | |
Total | 1231 | 730/473 | 47.4 ± 15.9 | 16.4 ± 11.8 | 100.0 |
(A) | |||||||
Effect | −2 Log-Likelihood for Reduced Model | Likelihood-Quotient Tests | |||||
Chi-Square | dF | Significance | |||||
Constant term | 1086.079 | 0.000 | 0 | 0.000 | |||
Stakeholder in entity group | 1111.436 | 25.357 | 12 | 0.013 | |||
Age | 1094.640 | 8.562 | 4 | 0.073 | |||
Gender | 1101.177 | 15.098 | 12 | 0.236 | |||
Availability of professional information | 1120.034 | 33.955 | 16 | 0.006 | |||
Modification of own decisions | 1262.868 | 176.789 | 16 | 0.000 | |||
Burden due to distress | 1598.556 | 512.477 | 16 | 0.000 | |||
Burden due to own risk | 1110.867 | 24.788 | 16 | 0.074 | |||
Own condition stress | 1120.687 | 34.608 | 12 | 0.001 | |||
Pandemic workload | 1112.688 | 26.609 | 16 | 0.046 | |||
(B) | |||||||
Observed | Predicted | ||||||
Not at All | A Little | Somewhat | A Lot | Completely | % Correct | % Correct with Neighbor | |
Not at all | 55 | 35 | 5 | 0 | 0 | 57.9% | 94.7% |
A little | 24 | 137 | 41 | 11 | 3 | 63.4% | 93.5% |
Somewhat | 4 | 37 | 113 | 12 | 1 | 67.7% | 97.0% |
A lot | 2 | 16 | 29 | 40 | 2 | 44.9% | 79.8% |
Completely | 0 | 0 | 2 | 2 | 13 | 76.5% | 88.2% |
% Total | 14.6% | 38.5% | 32.5% | 11.1% | 3.3% | 61.3% | 92.5% |
(A) | |||||||
Effect | −2 Log-Likelihood for Reduced Model | Likelihood-Quotient Tests | |||||
Chi-Square | dF | Significance | |||||
Constant term | 428.226 | 0.000 | 0 | 0.000 | |||
Age | 1101.176 | 672.950 | 4 | 0.000 | |||
Gender | 434.342 | 6.117 | 8 | 0.634 | |||
Stakeholder in entity group | 515.481 | 87.256 | 12 | 0.000 | |||
Modification of own decisions | 500.931 | 72.705 | 16 | 0.000 | |||
Burden due to own risk | 526.510 | 98.284 | 16 | 0.000 | |||
Burden due to distress | 442.304 | 14.078 | 16 | 0.593 | |||
Own condition stress | 502.116 | 73.891 | 12 | 0.000 | |||
Pandemic workload | 511.219 | 82.993 | 16 | 0.000 | |||
(B) | |||||||
Observed | Predicted | ||||||
Not at All | A Little | Somewhat | A Lot | Completely | % Correct | % Correct with Neighbor | |
Not at all | 4 | 0 | 1 | 1 | 0 | 66.7% | 66.7% |
A little | 0 | 11 | 6 | 8 | 0 | 44.0% | 68.0% |
Somewhat | 0 | 3 | 72 | 24 | 2 | 71.3% | 98.0% |
A lot | 0 | 2 | 28 | 55 | 4 | 61.8% | 97.8% |
Completely | 0 | 0 | 4 | 5 | 17 | 65.4% | 84.6% |
% Total | 1.6% | 6.5% | 44.9% | 37.7% | 9.3% | 64.4% | 92.7% |
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Haier, J.; Beller, J.; Adorjan, K.; Bleich, S.; de Greck, M.; Griesinger, F.; Heppt, M.; Hurlemann, R.; Mees, S.T.; Philipsen, A.; et al. Decision Conflicts in Clinical Care during COVID-19: A Multi-Perspective Inquiry. Healthcare 2022, 10, 1914. https://doi.org/10.3390/healthcare10101914
Haier J, Beller J, Adorjan K, Bleich S, de Greck M, Griesinger F, Heppt M, Hurlemann R, Mees ST, Philipsen A, et al. Decision Conflicts in Clinical Care during COVID-19: A Multi-Perspective Inquiry. Healthcare. 2022; 10(10):1914. https://doi.org/10.3390/healthcare10101914
Chicago/Turabian StyleHaier, Joerg, Johannes Beller, Kristina Adorjan, Stefan Bleich, Moritz de Greck, Frank Griesinger, Markus Heppt, René Hurlemann, Soeren Torge Mees, Alexandra Philipsen, and et al. 2022. "Decision Conflicts in Clinical Care during COVID-19: A Multi-Perspective Inquiry" Healthcare 10, no. 10: 1914. https://doi.org/10.3390/healthcare10101914