Older adults' beliefs about physician-estimated life expectancy: a cross-sectional survey

BACKGROUND: Estimates of life expectancy assist physicians and patients in medical decision-making. The time-delayed benefits for many medical treatments make an older adult's life expectancy estimate particularly important for physicians. The purpose of this study is to assess older adults' beliefs about physician-estimated life expectancy. METHODS: We performed a mixed qualitative-quantitative cross-sectional study in which 116 healthy adults aged 70+ were recruited from two local retirement communities. We interviewed them regarding their beliefs about physician-estimated life expectancy in the context of a larger study on cancer screening beliefs. Semi-structured interviews of 80 minutes average duration were performed in private locations convenient to participants. Demographic characteristics as well as cancer screening beliefs and beliefs about life expectancy were measured. Two independent researchers reviewed the open-ended responses and recorded the most common themes. The research team resolved disagreements by consensus. RESULTS: This article reports the life-expectancy results portion of the larger study. The study group (n = 116) was comprised of healthy, well-educated older adults, with almost a third over 85 years old, and none meeting criteria for dementia. Sixty-four percent (n = 73) felt that their physicians could not correctly estimate their life expectancy. Sixty-six percent (n = 75) wanted their physicians to talk with them about their life expectancy. The themes that emerged from our study indicate that discussions of life expectancy could help older adults plan for the future, maintain open communication with their physicians, and provide them knowledge about their medical conditions. CONCLUSION: The majority of the healthy older adults in this study were open to discussions about life expectancy in the context of discussing cancer screening tests, despite awareness that their physicians' estimates could be inaccurate. Since about a third of participants perceived these discussions as not useful or even harmful, physicians should first ascertain patients' preferences before discussing their life expectancies

From black and white to shades of grey : a longitudinal study of teachers’ perspectives on teaching sociocultural and subjective aspects of science

Traditional school science has been described as focused on indisputable facts where scientific processes and factors affecting these processes become obscured or left undiscussed. In this article, we report on teachers’ perspectives on the teaching of sociocultural and subjective aspects of the nature of science (NOS) as a way to accomplish a more nuanced science teaching in Swedish compulsory school. The teachers (N = 6) took part in a longitudinal study on NOS and NOS teaching that spanned 3 years. The data consists of recorded and transcribed focus group discussions from all 3 years. In the analysis, the transcripts were searched for teachers’ suggestions of issues, relevant for teaching in compulsory school, as well as opportunities and challenges connected to the teaching of these issues. The results of the analysis show that (a) the number of suggested issues increased over the years, (b) teachers’ ways of contextualizing the issues changed from general and unprecise to more tightly connected to socio-scientific or scientific contexts, and (c) the number of both opportunities and challenges related to NOS teaching increased over the years. The most evident changes occurred from the beginning of year 2 when the focus group discussions became more closely directed towards concrete teaching activities. Tensions between the opportunities and challenges are discussed as well as how these can be met, and made use of, in science teacher education