decision-making

decision-making

by Victoria Tang -

1. Codes we developed:

Family, friends, doctors that helped with decision-making

Individual ownership of decision

The burden of the decision as expressed by time, money, and stress

The lack of support as a barrier to decision-making

Age as a factor in decision-making

Satisfaction with decision based on outcome

Experience as a factor to current/future medical decision-making

The view of the decision: life or death vs. quality of life

 

Here are some examples of codes we kept:

 

Satisfaction with decision based on outcome:

“…the best decision I could have made because after the surgery, they did another biopsy and I knew exactly where I stood…it came out clean…”

 

Decision-making viewed as life or death:

“…the main thing I would consider was my life, not the side effects.”

“what would give me the best chance of surviving prostate cancer”

 

Experience as a factor to current/future medical decision-making:

“when I’m up for another decision…I’d like to know the procedure…”

“…I don’t want to have machines keeping me going like your mother-in-law and it lasted 9 months; it was 9 months of torture…”

“One of our animals got hurt. We shot him because we couldn’t save him…”

“Dr. Kevorkian…I think he had the right idea…”

 

2. Experiences applying the code to my data: experience as a factor to current/future medical decision-making.

My experiences with applying this code to my data were meaningful. When I went back through to re-read the transcript, I was able to find more examples of this throughout the transcript that I had not initially noted.

 

3. Self-reflexive and substantive memos:

The members of this focus group are using their experience to ground their decision. They are also using experiences to express what is important to them or what they would want for themselves in that situation, as well. Interestingly, they use not only personal experiences, such as previous decisions about proceeding with an operation but also their family member’s experiences, as noted with the mother-in-law being “tortured”. Interestingly, they used the example of Dr. Kevorkian, as well, to express their thoughts on end-of-life care and what they value. Dr. Kevorkian is a public figure and his story of physician assisted suicide may be an example of what this person would want for him/herself—comfort when faced with terminal illness, having the right to make the decision as to how to die. I think there is also an element of not having to make the decision as to when to die and having this decision made for you. The participant talks about the experience of shooting the animals when they couldn’t be saved.

 

Re: decision-making

by Jonathan Lee -
Interesting codes and thoughts! A few comments. 1. I feel like the codes may be a bit too wordy. This is probably a style thing also, but I've run into the issue where the codes I made are very wordy and they tend to then be very specific to exact statements rather than topics/concepts and you end up with a billion codes. For instance, the first code could be "Support with decision-making" and then you have another one for lack of support as well. 2. For the decision-making viewed as life or death code, I wonder if those quotes (at least the first one) are also getting at the quantity vs quality of life issue and how often this comes up in the transcripts. 3. I think the prior experience code is interesting and I wonder if that one actually needs to be broken down a bit. The examples seem fairly different to me from a prior personal decision, to one involving a family member, to one involving a pet, and then to the Dr. Kevorkian quote which I'm not sure actually fits in specifically.

Re: decision-making

by Laura -

Thank you for this post- it's really illuminating to me to see how you saw these data with fresh eyes.  You arrived at some similar things to what we pulled out of the data, and some new.  We ultimately looked at two major themes "what was important to people in making decisions," and "what were types of decisions that people made" (there weren't enough examples in this snippet of transcript to see the wide range of these, but they were all over the map).  So there was definitely some overlap-- your codes of relevant people, prior experiences, and sense of being a burden were each codes that we used. But we did not talk about the ideas of satisfaction with the decision based on outcome, which is a fascinating idea, or the impact of age (sort of lumped this with experience, but it is different).

I also did not touch this PAD reference at all, because it only came up once in the hundreds of pages, but it would be very interesting to see if it came up more often now than when this interview was conducted a few years ago!

 

Thanks again for your comments.

 

Re: decision-making

by Wendy Anderson -

Great job on this, and great comments from your colleagues.

Keep in mind that you want to go beyond a category in the data (e.g. what was important in making decisions) to actually say what was important to people.

One thing to think about in deciding what themes to focus on is what is surprising? interesting? what did you learn that you did not know before?

For example, in a study we did of ICU family members, we found they viewed things as decisions that providers probably didn't, like which rehab facility to go to. And they felt these decisions were maybe more important than stopping life support, which they didn't see as a decision because they would never do it.

Re: reflexive memos, think about and discuss how your world view might influence how you read the data, and also how did the data impact you personally.