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Brazilian Journal of Physical Therapy 2022Shared decision making is a means of translating evidence into practice and facilitating patient-centred care by helping patients to become more active in the... (Review)
Review
BACKGROUND
Shared decision making is a means of translating evidence into practice and facilitating patient-centred care by helping patients to become more active in the decision-making process. Shared decision making is a collaborative process that involves patients and clinicians making health-related decisions after discussing the available options; the benefits and harms of each option; and considering the patient's values, preferences, and personal circumstances.
METHODS
This paper describes what shared decision making is, why it is important, when it is appropriate, and key elements. We report on physical therapists' current use of and attitudes to shared decision making and explore factors that influence its uptake. Lastly, we examine what is needed to promote greater use of this approach.
RESULTS
Key elements in the shared decision making process are: identifying the problem that requires a decision; providing an explanation of the health problem, including, where appropriate, the natural history of the condition; discussing the available options and the potential benefits and harms of each option; eliciting the patient's values, preferences, and expectations; and assisting the patient to weigh up the options to reach an informed decision. When applied in practice, shared decision making has been found to improve patient-clinician communication; improve patients' accuracy of their expectations of intervention benefits and harms, involvement in decision-making, and feeling of being informed; and increase both patients' and clinicians' satisfaction with care.
CONCLUSION
Despite physical therapists' enthusiasm for shared decision making, uptake of this approach has been slow. Multi-level strategies and behaviour change are required to encourage and support the sustainable incorporation of shared decision making in practice.
Topics: Decision Making; Decision Making, Shared; Humans; Patient Participation; Patient-Centered Care; Physical Therapy Modalities
PubMed: 35063699
DOI: 10.1016/j.bjpt.2021.100382 -
Neurobiology of Learning and Memory Jan 2015
Topics: Animals; Brain; Decision Making; Humans; Memory
PubMed: 25192867
DOI: 10.1016/j.nlm.2014.08.014 -
Neuroscience and Biobehavioral Reviews May 2020The scientific study of animal affect (emotion) is an area of growing interest. Whilst research on mechanism and causation has predominated, the study of function is... (Review)
Review
The scientific study of animal affect (emotion) is an area of growing interest. Whilst research on mechanism and causation has predominated, the study of function is less advanced. This is not due to a lack of hypotheses; in both humans and animals, affective states are frequently proposed to play a pivotal role in coordinating adaptive responses and decisions. However, exactly how they might do this (what processes might implement this function) is often left rather vague. Here we propose a framework for integrating animal affect and decision-making that is couched in modern decision theory and employs an operational definition that aligns with dimensional concepts of core affect and renders animal affect empirically tractable. We develop a model of how core affect, including short-term (emotion-like) and longer-term (mood-like) states, influence decision-making via processes that we label affective options, affective predictions, and affective outcomes and which correspond to similar concepts in schema of the links between human emotion and decision-making. Our framework is generalisable across species and generates questions for future research.
Topics: Affect; Animals; Behavior, Animal; Decision Making; Models, Biological
PubMed: 31991192
DOI: 10.1016/j.neubiorev.2020.01.025 -
Topics in Cognitive Science Jan 2022Humans make decisions in dynamic environments (increasingly complex, highly uncertain, and changing situations) by searching for potential alternatives sequentially over...
Humans make decisions in dynamic environments (increasingly complex, highly uncertain, and changing situations) by searching for potential alternatives sequentially over time, to determine the best option at a precise moment. Surprisingly, the field of behavioral decision making has little to offer in terms of theoretical principles and practical guidelines on how people make decisions in dynamic situations. My research program aims to fill in this gap by developing theoretical understandings of decision processes as well as practical demonstrations of how these theoretical developments can improve human dynamic decision making. Throughout my research career, I have helped create, test, and improve a general theory of dynamic decision making, instance-based learning theory, IBLT. The methods I have used to contribute to IBLT are (1) laboratory experiments that rely on dynamic games in which humans make choices over time and space, individually and in teams, and from which we extrapolate robust phenomena and behavioral insights; and (2) computational, actionable cognitive models, which specify the decision-making process and the cognitive mechanisms involved into a computational algorithm. The combination of these methods spawned novel applications in areas such as cybersecurity, phishing, climate change, and human-machine interactions. In this paper, I will take you through my own intellectual exploratory experience of computational modeling of human decision processes, and how the integration of experimental work and cognitive modeling helped in discovering and uncovering the field of dynamic decision making.
Topics: Decision Making; Humans; Learning; Uncertainty
PubMed: 34767300
DOI: 10.1111/tops.12581 -
Therapeutische Umschau. Revue... 2022
Topics: Decision Making; Decision Making, Shared; Humans; Patient Participation
PubMed: 36164736
DOI: 10.1024/0040-5930/a001374 -
Biological Psychiatry May 2022Obesity is a heterogeneous condition that is affected by physiological, behavioral, and environmental factors. Value-based decision making is a useful framework for... (Review)
Review
Obesity is a heterogeneous condition that is affected by physiological, behavioral, and environmental factors. Value-based decision making is a useful framework for integrating these factors at the individual level. The disciplines of behavioral economics and reinforcement learning provide tools for identifying specific cognitive and motivational processes that may contribute to the development and maintenance of obesity. Neuroeconomics complements these disciplines by studying the neural mechanisms underlying these processes. We surveyed recent literature on individual decision characteristics that are most frequently implicated in obesity: discounting the value of future outcomes, attitudes toward uncertainty, and learning from rewards and punishments. Our survey highlighted both consistent and inconsistent behavioral findings. These findings underscore the need to examine multiple processes within individuals to identify unique behavioral profiles associated with obesity. Such individual characterization will inform future studies on the neurobiology of obesity as well as the design of effective interventions that are individually tailored.
Topics: Decision Making; Humans; Neurobiology; Obesity; Reinforcement, Psychology; Reward
PubMed: 34861975
DOI: 10.1016/j.biopsych.2021.09.019 -
The Patient Dec 2020
Topics: Decision Making; Decision Making, Shared; Health Personnel; Humans; Patient-Centered Care; Self Care
PubMed: 33051858
DOI: 10.1007/s40271-020-00471-2 -
Current Opinion in Neurobiology Apr 2018Rodent decision-making research aims to uncover the neural circuitry underlying the ability to evaluate alternatives and select appropriate actions. Designing behavioral... (Review)
Review
Rodent decision-making research aims to uncover the neural circuitry underlying the ability to evaluate alternatives and select appropriate actions. Designing behavioral paradigms that provide a solid foundation to ask questions about decision-making computations and mechanisms is a difficult and often underestimated challenge. Here, we propose three dimensions on which we can consider rodent decision-making tasks: ethological validity, task complexity, and stimulus-response compatibility. We review recent research through this lens, and provide practical guidance for researchers in the decision-making field.
Topics: Animals; Behavior, Animal; Decision Making; Electronic Data Processing; Ethology; Humans; Models, Animal
PubMed: 29179005
DOI: 10.1016/j.conb.2017.11.001 -
Neuroscience and Biobehavioral Reviews Sep 2018Studies in the field of social neuroscience have recently made use of computational models of decision-making to provide new insights into how we learn about the self... (Review)
Review
Studies in the field of social neuroscience have recently made use of computational models of decision-making to provide new insights into how we learn about the self and others during social interactions. Importantly, these studies have increasingly drawn attention to brain areas outside of classical cortical "social brain" regions that may be critical for social processing. In particular, two portions of the ventral anterior cingulate cortex (vACC), subgenual anterior cingulate cortex and perigenual anterior cingulate cortex, have been linked to social and self learning signals, respectively. Here we discuss the emerging parallels between these studies. Uncovering the function of vACC during social interactions could provide important new avenues to understand social decision-making in health and disease.
Topics: Brain Mapping; Decision Making; Gyrus Cinguli; Humans; Interpersonal Relations
PubMed: 29886177
DOI: 10.1016/j.neubiorev.2018.05.030 -
Neuropsychologia Mar 2011Decision-making is a complex process that requires the orchestration of multiple neural systems. For example, decision-making is believed to involve areas of the brain...
Decision-making is a complex process that requires the orchestration of multiple neural systems. For example, decision-making is believed to involve areas of the brain involved in emotion (e.g., amygdala, ventromedial prefrontal cortex) and memory (e.g., hippocampus, dorsolateral prefrontal cortex). In this article, we will present findings related to the amygdala's role in decision-making, and differentiate the contributions of the amygdala from those of other structurally and functionally connected neural regions. Decades of research have shown that the amygdala is involved in associating a stimulus with its emotional value. This tradition has been extended in newer work, which has shown that the amygdala is especially important for decision-making, by triggering autonomic responses to emotional stimuli, including monetary reward and punishment. Patients with amygdala damage lack these autonomic responses to reward and punishment, and consequently, cannot utilize "somatic marker" type cues to guide future decision-making. Studies using laboratory decision-making tests have found deficient decision-making in patients with bilateral amygdala damage, which resembles their real-world difficulties with decision-making. Additionally, we have found evidence for an interaction between sex and laterality of amygdala functioning, such that unilateral damage to the right amygdala results in greater deficits in decision-making and social behavior in men, while left amygdala damage seems to be more detrimental for women. We have posited that the amygdala is part of an "impulsive," habit type system that triggers emotional responses to immediate outcomes.
Topics: Amygdala; Choice Behavior; Decision Making; Emotions; Female; Functional Laterality; Humans; Male; Sex Factors
PubMed: 20920513
DOI: 10.1016/j.neuropsychologia.2010.09.029