According to the American Psychological Association (2006), three components should be equally considered in treatment decision-making: empirical research, clinical judgment, and the client’s values and preference. Swift, Callahan, and Vollmer (2011) defined client preferences as specific attributes that are desired in a therapeutic setting and are divided into three categories: role, therapist, and treatment-type. Currently, there is no treatment orientation scale that measures treatment type and magnitude of the relationship. For this initial phase of development, 5 treatment orientations are being used as the basis of the Client Treatment Orientation Scale (CTOS): psychodynamic, existential, cognitive-behavioral therapy, acceptance and commitment therapy, and multicultural. The purpose of this study is to begin development of a treatment orientation scale with 5-7 questions per subscale domain. A total sample of 651 participants completed the survey, was English speaking, and aged 18 or over, with the majority being male (n = 334, 51.3%). The mean age of participants was 31.91 (SD = 8.23), with an equal distribution of degree type (e.g. psychiatrist, clinical psychology, counseling psychology, and school psychology) with psychiatry the most endorsed at 26.6% (n = 173). Overall, results did not support the use of the CTOS in applied or research settings. Reliability analyses for the 5 subscales were: psychodynamic (α = .52), existential (α = .32), cognitive-behavioral therapy (α = .64), acceptance and commitment therapy (α = .46), and multicultural (α = .63). There were various limitations of the study, such as being self-report and the possibility of not being representative of the particular orientations being measured. Future research could re-examine items for latent variables or refine the current items for another factor analysis study.

Culturally sensitive care is thought to take into account a person's specific cultural values and preferences when providing mental health care services. Latinos currently comprise 17% of the total U.S. population at 50.5 million and persons of Mexican heritage constitute over 66% of all Latinos in the United States. Persons of Mexican heritage experience higher rates of mental health issues and illness with 30% lifetime incidence versus 20% incidence for Anglos. Few studies have focused on the mental health treatment preferences for persons of Mexican heritage. Treatment preferences could reflect personal characteristics, acculturation perspective about mental health issues and illness, and experience with treatment. Mass media may also influence treatment preferences and mental health information-seeking.The purpose of this study was to describe preferences for mental health treatment services for persons of Mexican heritage living in the Southwest along the United States-Mexico border. Twenty-one participants were interviewed individually and their responses analyzed using Atlas-ti qualitative analysis software. The participants reported twenty-five mental health treatment preferences. The top six preferences- medication, going to the doctor, social and family support, counseling and herbal medicines, were consistent throughout demographic categories of age, gender, income, generational status, insurance status, education, and acculturation. Self-management interventions and integrative medicine were also reported as treatment preferences. Participants reported media use of television, internet, books and magazines, in-person interaction, and radio as primary mental health information sources. Media influences on mental health included education/information, hope, normalization, and a catalyst for conversation. Ascribed meanings for anxiety, depression, substance abuse, schizophrenia, and bipolar disorder included cognitive, behavioral, and interactional reports. Mental health services for persons of Mexican heritage should include varying holistic mental health treatment practices, recognizing the need for understanding of potential meanings for mental health issues and illness. Persons of Mexican heritage report the desire for the same types of allopathic care including medications and counseling as Anglos in the US. Additionally, self-management interventions and integrative medicine therapies, as well as innovative media outreach methods were reported as integral to the holistic treatment process of obtaining help for mental health issues and illness.

The purpose of this study was to delineate variables which relate to reported willingness to seek treatment for menstrual-related distress, and to assess treatment preferences in a population of women often tapped for menstrual research that of college students. Of the 198 volunteers included in the study, 71 stated that they were willing to seek some form of treatment for menstrual-related distress, and 127 stated that they were not willing to do so. The Adjective Checklist (ACL), Menstrual Attitude Questionnaire (MAQ), and Menstrual Distress Questionnaire (MDQ), along with a personal data sheet were administered to subjects. In addition, they were asked to read three paragraph-long descriptions of self-administered, medical, and behavioral treatments for menstrual-related distress and to indicate their preference for each.

No description available.

<p dir="ltr">Patients who are aware of their terminal cancer prognosis are more likely to receive end-of-life care consistent with their values. However, prognostic awareness has shown mixed associations with quality of life (QoL) outcomes. Based on theories of acceptance (i.e., Erikson’s stages of life development, Kubler-Ross’s stage model of grief, coping theories) and the Ottawa Decision Support Framework, acceptance of cancer may moderate relationships between prognostic awareness and QoL outcomes and end-of-life treatment preferences. Dyadic coping theories, such as the Systemic Transactional Model and the Dyadic Cancer Outcomes Framework, suggest that patients’ degree of prognostic awareness and acceptance of their illness may also impact their family caregivers’ QoL and end-of-life treatment preferences for the patient. The aim of the present study was to examine the potential moderating role of patient acceptance of cancer in the relationships between patient prognostic awareness and both patient and caregiver QoL and end-of-life treatment preferences. This study was a secondary analysis of cross-sectional data from advanced cancer patients (<i>n</i> = 243) and their caregivers (<i>n</i> = 87) enrolled in the multi-institutional Coping with Cancer-II study. Patient outcomes of physical, psychological, and existential QoL were examined in a moderation path analysis. Caregiver physical and psychological QoL were examined in separate moderation regressions. Patient and caregiver end-of-life treatment preferences were examined in multiple logistic regression moderation models. Results did not support my hypothesis, as patient illness acceptance did not moderate the relationships between patient prognostic awareness and patient and caregiver QoL outcomes and end-of-life treatment preferences. However, there were significant main effects of patient illness acceptance on their own physical, psychological, and existential QoL as well as caregiver psychological QoL. There were also significant main effects of patient prognostic awareness on their own physical QoL and both their own and their caregivers’ end-of-life treatment preferences. Findings suggest that increasing patient’s prognostic awareness and illness acceptance may help improve values-consistent end-of-life care and QoL outcomes in advanced cancer patient-caregiver dyads. Findings support timely conversations to promote advanced cancer patients’ prognostic awareness as well as further research examining the impact of acceptance-based interventions in advanced cancer.</p>

Purpose: Patients living with advanced heart failure experience dyspnea, fatigue, poor quality of life, depression and cognitive impairment which may threaten their ability to provide informed consent to undergo heart transplant (HTx) or mechanical support (LVAD). Using qualitative and quantitative methods, we asked how patients with advanced heart failure make decisions regarding HTx and LVAD. The variables chosen to reflect the elements of consent included quality of life and symptom severity (voluntariness), depression and cognitive impairment (capacity) and treatment preferences (decision-making). Methods: 76 patients enrolled in the quantitative arm completed the Minnesota Living with Heart Failure Questionnaire; Visual Analog scales for dyspnea, fatigue and overall health; Beck Depression Inventory; Montreal Cognitive Assessment; Standard Gamble and Time Tradeoff. Qualitative methods were used to discover concepts, relationships and decision-making processes described by 17 of the 76 patients considering HTx and LVAD. Results: Patients reported poor quality of life and high symptom severity scores which compelled them to consider surgery as a way to relieve unpleasant symptoms and improve quality of life. Although 30% of patients had evidence of depression and/or cognitive impairment, no patient was deemed incapable of decision-making. Patients were willing to take considerable risk (35%) and trade considerable time (4months) to improve their health. While heart failure-related concepts were important to the decision, entrustment emerged as the meaningful process for decision-making. Conclusions: Patients who participated in this study were capable of decision-making and understood the risks associated with the surgery. Voluntariness was diminished by disease but not absent, and decisions were free of coercion. These results suggest the entrustment model of decision-making is the dominant process for patients considering high-risk surgical procedures and meets criteria for informed consent. Understanding the process of decision-making will help clinicians support and enable treatment decisions made by patients living with advanced heart failure.

Purpose: Patients living with advanced heart failure experience dyspnea, fatigue, poor quality of life, depression and cognitive impairment which may threaten their ability to provide informed consent to undergo heart transplant (HTx) or mechanical support (LVAD). Using qualitative and quantitative methods, we asked how patients with advanced heart failure make decisions regarding HTx and LVAD. The variables chosen to reflect the elements of consent included quality of life and symptom severity (voluntariness), depression and cognitive impairment (capacity) and treatment preferences (decision-making). Methods: 76 patients enrolled in the quantitative arm completed the Minnesota Living with Heart Failure Questionnaire; Visual Analog scales for dyspnea, fatigue and overall health; Beck Depression Inventory; Montreal Cognitive Assessment; Standard Gamble and Time Tradeoff. Qualitative methods were used to discover concepts, relationships and decision-making processes described by 17 of the 76 patients considering HTx and LVAD. Results: Patients reported poor quality of life and high symptom severity scores which compelled them to consider surgery as a way to relieve unpleasant symptoms and improve quality of life. Although 30% of patients had evidence of depression and/or cognitive impairment, no patient was deemed incapable of decision-making. Patients were willing to take considerable risk (35%) and trade considerable time (4months) to improve their health. While heart failure-related concepts were important to the decision, entrustment emerged as the meaningful process for decision-making. Conclusions: Patients who participated in this study were capable of decision-making and understood the risks associated with the surgery. Voluntariness was diminished by disease but not absent, and decisions were free of coercion. These results suggest the entrustment model of decision-making is the dominant process for patients considering high-risk surgical procedures and meets criteria for informed consent. Understanding the process of decision-making will help clinicians support and enable treatment decisions made by patients living with advanced heart failure.