Query: decision-making anxiety

title: Effects of interoceptive training on decision making, anxiety, and somatic symptoms
abstract: Interoception is the perception of afferent information that arises from any point within the body. Individual differences in interoception have been associated with affective processing and decision making processing. The somatic marker hypothesis summarizes the potential effects of interoception on decision making processes. According to this theory, individuals with interoceptive dysfunction exhibit disadvantageous decision making. Recently, enhancement of interoceptive accuracy, an element of interoception assessed by objective decision making tasks, has been demonstrated using biofeedback. Garfinkle et al. developed an interoceptive training task, modified from the heartbeat perception task, which enhanced interoceptive accuracy and reduced anxiety symptoms. The purpose of this study was to determine the effects of interoceptive training on decision making processes. Based on improvements in interoceptive accuracy, we hypothesized that decision making scores would change in a manner indicative of increased rationality.  This longitudinal interventional study was performed with interoceptive training. Before and after the intervention, interoceptive accuracy and rationality of decision making processes were assessed using a heartbeat perception task and rational decision making tasks, respectively. Fourteen healthy volunteers (nine women; mean age, 21.9 4.5 years) participated. The analysis included data from 12 participants. To detect individual differences in the effects of interoceptive accuracy on rationality of decision making, correlation analysis was conducted on change ratios of the indices of interoceptive accuracy and rationality of decision making.  Interoceptive training resulted in significant enhancement of interoceptive accuracy scores and significant reductions in somatic symptom and state anxiety scores. In contrast, interoceptive training did not cause significant changes in decision making indices. There was a significant positive correlation between change ratios of indices of interoceptive accuracy and rationality of decision making.  The results suggested a causal relation between interoception and rationality of decision making. These findings will enhance the understanding of mechanisms underlying alterations of decision making related to psychotherapy by focusing on interoception.

title: Decision Making in Young Adults: Towards a Better Understanding of Individual Differences in Decision Making Anxiety

title: A Randomized Controlled Trial Comparing Learners' Decision making, Anxiety, and Task Load During a Simulated Airway Crisis Using Two Difficult Airway Aids
abstract: ASA) difficult airway algorithm and the Vortex approach are difficult airway aids. Our objective was to demonstrate that a simpler cognitive model would facilitate improved decision making during a process such as difficult airway management. We hypothesized the simpler Vortex approach would be associated with less anxiety and task load.  Medical students were randomized to the ASA algorithm (n 33) or Vortex approach (n 34) All learned basic airway techniques on day 1 of their rotation. Next, they watched a video of their respective aid then managed a simulated airway crisis. We assessed decision making using a seven point airway management score and a completeness score. Completeness was at least one attempt at each of four techniques (mask ventilation, supraglottic airway, intubation, and cricothyrotomy) Two validated tools, the State Trait Anxiety Inventory Form Y and the National Aeronautics and Space Administration Task Load Index, were used to assess anxiety and task load.  Students in the Vortex group had higher airway management scores [4.0 (interquartile range 4.0 to 5.0) vs. 4.0 (3.0 to 4.0) P 0.0003] and completeness (94.1% vs. 63.6% P 0.003) In the ASA group, the means (SD) of National Aeronautics and Space Administration Task Load Index scores of 55 or higher were observed in mental [61.4 (14.4) temporal [62.3 (22.9) and effort [57.1 (15.6) domains. In the Vortex group, only the temporal load domain was 55 or higher [mean (SD) 57.8 (25.4) There was no difference in anxiety.  Medical students perform better in a simulated airway crisis after training in the simpler Vortex approach to guide decision making. Students in the ASA group had task load scores indicative of high cognitive load.

title: Relationships between Oncologist Gender, Participatory Decision Making, Anxiety and Breast Cancer Care
abstract: The discovery that adjuvant treatment (chemotherapy and radiotherapy) after lumpectomy contributes to high survival rates has been a groundbreaking development in modern breast cancer care. Participatory decision making (PDM) is a communication style that involves active interactions and discourse between doctors and patients. Although the receipt of adjuvant therapy for various types of cancers has been found to be linked to differences in patient physician communication, few studies have explored whether this relationship exists in breast cancer treatment. The present study, one of the first explicitly to examine demographic and psychosocial factors that may be related to adjuvant treatment rates, surveyed a sample of inner city breast cancer patients (N 105) about the type of care they received, assessing concomitant levels of participatory decision making (PDM) and anxiety. The results demonstrated that patients who indicated higher PDM tended to have lower levels of anxiety (p .01) Breast cancer patients who saw female oncologists were more likely to receive adjuvant treatment than breast cancer patients who saw male oncologists (p .05) Contrary to popular belief, patients reported equivalent levels of PDM and anxiety regardless of their physician's gender or their receipt of adjuvant treatment. The surprisingly low adjuvant treatment rates (45% in this sample suggest possible system failures in breast cancer care and indicate that more attention needs to be given to public education on the importance of receiving follow up treatment in breast cancer care.

title: The effect of antenatal anaesthetic consultation on maternal decision making, anxiety level and risk perception in obese pregnant women.
abstract: Obese parturients are recognised as high risk and an antenatal anaesthetic consultation is recommended. The potential positive and negative effects of this consultation have not been investigated. This prospective observational study aimed to determine if antenatal anaesthetic consultation affects decisional conflict, anxiety scores or risk perception in obese women planning vaginal delivery.  Eligible women had a body mass index of or 35 kg/m2, planning a vaginal delivery, aged or 18 years and able to complete a questionnaire presented in English. Before their anaesthetic consultation, women completed a written decisional conflict questionnaire, the Six Point Short Form of the Speilberger State Trait Anxiety Inventory and two questions regarding risk perception. All questions were repeated by telephone consultation two weeks later. Independent samples t tests were used to detect differences between pre and post test scores.  Of 114 women recruited, 89 completed the protocol and were analysed. Women had a mean SD age of 29.4+ 5.2 years and body mass index of 43.6+ 5.6 kg/m2. Decisional conflict scores were significantly lower after the consultation (30.04 vs. 16.54, P<0.001) Anxiety scores were lower (9.41 vs. 8.49, P=0.002) but this was not clinically significant. Only 19.1% of women felt their health was at risk in pregnancy; this did not change after the consultation. Thirteen women changed their preference toward epidural analgesia (P=0.01) DISCUSSION Our results support the current practice of referral of obese parturients for anaesthetic consultation, but demonstrate that most women remain unaware of the risks of obesity in pregnancy despite anaesthetic consultation.

title: Relationships between Oncologist Gender Participatory Decision Making Anxiety and Breast Cancer Care
abstract: The discovery that adjuvant treatment (chemotherapy and radiotherapy) after lumpectomy contributes to high survival rates has been a groundbreaking development in modern breast cancer care. Participatory decision making (PDM) is a communication style that involves active interactions and discourse between doctors and patients. Although the receipt of adjuvant therapy for various types of cancers has been found to be linked to differences in patient physician communication, few studies have explored whether this relationship exists in breast cancer treatment. The present study, one surveyed a sample of inner city breast cancer patients (N 105) about the type of care they received, assessing concomitant levels of participatory decision making (PDM) and anxiety. The results demonstrated that patients who indicated higher PDM tended to have lower levels of anxiety (p .01) Breast cancer patients who saw female oncologists were more likely to receive adjuvant treatment than breast cancer patients who saw male oncologists (p .05) Contrary to popular belief, patients reported equivalent levels of PDM and anxiety regardless of their physician's gender or their receipt of adjuvant treatment. The surprisingly low adjuvant treatment rates (45% in this sample suggest possible system failures in breast cancer care and indicate that more attention needs to be given to public education on the importance of receiving follow up treatment in breast cancer care.

title: Faculty Opinions recommendation of The effect of antenatal anaesthetic consultation on maternal decision making, anxiety level and risk perception in obese pregnant women.

title: An Analysis of the Influencing Factors of College Students' Career Decision making Anxiety
abstract: The college students' anxiety of career decision making is a common problem.This paper,based on the analysis of the process and manifestation of the career decision making anxiety,studied the impact of three factors of career decision making anxiety the internal and external stimuli and the cognitive evaluations,and suggested that university should take actions to resolve or reduce anxiety,such as establishing an education system to improve the students' capability for career decision making,cultivating students' ability to release stress through solving the problems,and enhancing the students' skills training,etc.

title: Relationships between graduates' career decision making anxiety, career decision making self efficacy and employment pressure coping style

title: Relationship between physicians' death anxiety and medical communication and decision making: A systematic review.
abstract: To examine the relationship between physicians' death anxiety and medical communication and decision making. It was hypothesized that physicians' death anxiety may lead to the avoidance of end of life conversations and a preference for life prolonging treatments.  PubMed and PsycInfo were systematically searched for empirical studies on the relation between physicians' death anxiety and medical communication and decision making.  This review included five quantitative and two qualitative studies (N 7) Over 38 relations between death anxiety and communication were investigated, five were in line with and one contradicted our hypothesis. Physicians' death anxiety seemes to make end of life communication more difficult. Over 40 relations between death anxiety and decision making were investigated, three were in line with and two contradicted the hypothesis. Death anxiety seemes related to physicians' guilt or doubt after a patient's death.  There was insufficient evidence to confirm that death anxiety is related to more avoidant communication or decision making. However, death anxiety does seem to make end of life communication and decision making more difficult for physicians.  Education focused on death and dying and physicians' emotions in medical practice may improve the perceived ease with which physicians care for patients at the end of life.