The bigger picture of shared decision making:A service design perspective using the care path of locally advanced pancreatic cancer as a case

Purpose: Solutions to improve the implementation of shared decision making (SDM) in oncology often focus on the consultation, with limited effects. In this study, we used a service design perspective on the care path of locally advanced pancreatic cancer (LAPC). We aimed to understand how experiences of patients, their significant others, and medical professionals over the entire care path accumulate to support their ability to participate in SDM. Participants and methods: We used qualitative interviews including design research techniques with 13 patients, 13 significant others, and 11 healthcare professionals, involved in the diagnosis or treatment of LAPC. The topic list was based on the literature and an auto-ethnography of the illness trajectory by a caregiver who is also a service design researcher. We conducted a thematic content analysis to identify themes influencing the ability to participate in SDM. Results: We found four interconnected themes: (1) Decision making is an ongoing and unpredictable process with many decision moments, often unannounced. The unpredictability of the disease course, tumor response to treatment, and consequences of choices on the quality of life complicate decision making; (2) Division of roles, tasks, and collaboration among professionals and between professionals and patients and/or their significant others is often unclear to patients and their significant others; (3) It involves “work” for patients and their significant others to obtain and understand information; (4) In “their disease journey,” patients are confronted with unexpected energy drains and energy boosts, that influence their level of empowerment to participate in SDM. Conclusion: The service design perspective uncovered how the stage for SDM is often set outside the consultation, which might explain the limited effect currently seen of interventions focusing on consultation itself. Our findings serve as a starting point for (re)designing care paths to improve the implementation of SDM in oncology.</p

Metro Mapping:development of an innovative methodology to co-design care paths to support shared decision making in oncology

Treatment decision-making can be complex, notably when there are multiple treatments available, with different (probabilities of) benefits and harms, for example, survival and side effects.1 It is precisely in these complex situations that the preferences of the patient are of utmost importance, as the trade-offs of benefits and harms are subjective and concern patients' lives.2 In such trade-offs, shared decision making (SDM) has gained momentum as a strategy to include both the best available evidence and the patient's preferences.3</p

L'intérêt d'utiliser des instructions audiovisuelles dans le cadre d'un design expérimental à tâches complexes et multiples :illustration par un cas réel

Lors d'une expérimentation en laboratoire, l'un des enjeux est de limiter les sources d'erreurs aléatoires et systématiques de mesure du comportement. L'une de ces sources d'erreurs provient notamment de la communication des instructions expérimentales au répondant. Ce biais peut cependant être fortement réduit en standardisant les instructions au plan du message communiqué et de l'explication des tâches à exécuter. Le but de ce papier pédagogique est d'illustrer les avantages - en terme de standardisation - existant à utiliser des instructions enregistrées sur bandes audiovisuelles plutôt que des instructions orales

What was Phillippe Starck thinking of?

No abstract available

Visual typicality and novelty as joint predictors of aesthetic preference : the influence of design expertise and product category interest

Extended abstrac

A grounded typology of vacation decision-making

This paper presents a typology of vacationers based on decision-making variables and processes. Employing a naturalistic perspective, the (summer) vacation decision-making process of 25 Belgian households was followed for a year. In-depth interview and observation data were analyzed and interpreted through the grounded theory methodology. Findings show that vacation decision-making is an ongoing process with a lot of contextual influences. A distinction is made between six types of vacationers: habitual, rational, hedonic, opportunistic, constrained and adaptable. This new typology may be useful for both theoretical and segmentation purposes