Shared decision-making, treatment decision regret, and vision-related quality of life among parents of children with myopia: An online survey in Taiwan.

OBJECTIVES: To investigate the relationships among myopia treatment, decision regret, shared decision-making, and vision-related quality of life among parents of 6-12-year-old children with myopia. METHODS: An online Google Forms questionnaire was developed using a cross-sectional design and distributed between January 16 and August 22, 2023. Parents of 6-12-year-old children with myopia were recruited through school nurses working in Taiwan. The children's and parents' demographic data were collected. Study instruments included the Decisional Regret Scale, Shared Decision-Making, and Vision-Related Quality of Life questionnaires. Multivariable linear regression analysis was used to identify factors influencing vision-related quality of life. RESULTS: Of 350 parents contacted, 314 questionnaires were analyzed. Among the respondents, 77.39 % (n = 243) were mothers, and most were aged >40 years. The mean age of children at myopia diagnosis was 7.12 ± 1.24 years; 46.50 % had < - 1.0 diopters of refractive error. Atropine eye drops were the primary treatment; 17.71 % of children were prescribed orthokeratology for myopia control. Parents reported low levels of decision regret and moderate levels of shared decision-making and vision-related quality of life. Children's age, use of orthokeratology lenses, decision regret, and shared decision-making significantly influenced the vision-related quality of life reported by the parents, accounting for 22.5 % of the variance. CONCLUSION: The study's findings emphasize the importance of addressing decision regret and promoting shared decision-making in myopia treatment. Eye care professionals should discuss treatment options thoroughly before making decisions. Through shared decision-making, parents can make informed choices about treatments based on a comprehensive understanding of the benefits and drawbacks, ultimately benefitting children's vision health.

Assessing Decisional Regret Among Biobank Sample Donors.

Background: Large biobanks that link biological specimens with specimen donors' health histories are a critical tool for precision medicine, and many health care institutions have invested significant resources in setting up and building up large collections for this purpose. As biobanks require consented participation from thousands of individual donors, much research has focused on the values and preferences of new and prospective donors who are actively contemplating an invitation to participate in the collection. Few studies, however, have focused on participants' opinions about their biobank participation in the months and years following enrollment. Methods: We conducted a survey in a large, established biobank and evaluated participants' levels of decisional regret regarding their decision to enroll in the biobank. Results: We found very low levels of decisional regret among established biobank participants. Multivariable regression analysis found that age, length of time in the biobank, lower educational attainment, inadequate health literacy, and previous invitations to research participation were all significant predictors of elevated regret. Discussion: Among those with elevated regret, several demographic factors may point to elevated likelihood of decisional regret. More research is needed to identify factors associated with long-term satisfaction with biobank participation and with elevated risk of regret and/or withdrawal from the collection.

Post-operative patient perception of decisional regret in cochlear implant recipients.

IMPORTANCE: Decision regret post-surgery has has been linked to health outcomes for a number of elective procedures but is understudied in cochlear implantation satisfaction. Theunpredictability in outcomes may lead to unmet expectations by the recipient. This study is the first study to investigate the decision regret concept in cochlear implant recipients. OBJECTIVE: Tto investigate post-operative decision regret in (CI) recipients. DESIGN: This was a prospective cohort study using the validated Ottawa Decision Regret Scale, and whether the CI met the patient's expectations. Variables potentially associated with decision regret including patient demographics, post-operative speech perception scores, duration of deafness, duration of CI use and age were analyzed using the logistic regression model. SETTING: This was a multi-center study. Participants were recruited and enrolled from the University of Miami and the University of Kansas in an outpatient setting. PARTICIPANTS: Adult, English-speaking CI recipients with at least 6 months of listening experience with their implant. RESULTS: Out of 173 58% reported no regret, 27% reported mild, and 15% reported moderate-to-strong regret. Expectations were met in 77% while not meeting expectations in 14%. The remaining 8% were neutral. Decisional regret was significantly associated (p = 0.02) with poor post-operative speech perception. No other variables were associated with regret. CONCLUSIONS: Post-operative decision regret was reported by 42% of CI recipients. Poor speech perception abilities were associated with increased risk of regret. Further research is required to identify regret risks and provide resources to mitigate regret in CI recipients.

Professional Burnout and Career Choice Regret in Urology Residents.

PURPOSE OF REVIEW: High rates of professional burnout and career choice regret among urology residents may increase professional dissatisfaction, shorten career longevity, and exacerbate urology workforce shortages. Understanding the prevalence of and risk factors for burnout may help develop interventions. RECENT FINDINGS: Up to 48% of contemporary U.S. urology residents experience burnout symptoms, including up to 70% of second-year residents. Among overlapping personal, professional, institutional, and lifestyle risk factors, barriers to accessing medical and mental health care are frequently cited as an important association in residents. Limited intervention studies suggest that providing basic needs, such as on-call meals, and facilitating physical wellness and social engagement among residents may result in sustained reductions in burnout. Urology residents continue to experience high rates of burnout and career choice regret among medical specialties. Evidence-based interventions and sustainable policies that address primary risk factors are urgently needed.

Episodic Future Thinking Increases Quitting Intention and Reduces Cigarette Consumption: The Role of Anticipated Regret.

Background: Episodic future thinking (EFT), which refers to people simulating possible future life events, has been suggested as a promising intervention for substance use disorders. Objectives: To examine the effect of gain-oriented and loss-oriented EFT on smoking cessation and its underlying mechanisms. Results: Two online experiments were conducted (Total N = 362). The results suggested that engaging in EFT led to increased short-term quitting behavior among smokers by bolstering their intentions to quit smoking (indirect effect = 0.10, bootstrap = 5000, bias-corrected 95% CI [0.0008, 0.2353]). Furthermore, the influence of EFT on quitting intention was mediated by anticipated regret (indirect effect = 0.37, bootstrap = 5000, bias-corrected 95% CI [0.2062, 0.5321]). There were no significant differences observed between the effects of gain-oriented and loss-oriented EFT on quitting intention (F = 0.28, p = .60). Importance: Our findings contribute to a growing body of literature on the adaptive functioning of EFT and lend support to the regret regulation theory. Health practitioners may consider integrating EFT into clinical interventions to help smokers quit smoking.

Age matters: The effect of regret and loss aversion on cultured meat acceptance.

Cultured meat shows great promise as a more sustainable alternative to conventional meat consumption. However, consumer acceptance of cultured meat remains a great challenge as studies indicate a general reluctance to adopt this product. Notably, while existing literature has provided various factors influencing consumer acceptance of cultured meat, there is a limited focus on the use of affective cues. The present research examines the impact of regret appeal on consumers' willingness to try cultured meat. In two experimental studies, the authors investigate (1) the interactive effect between regret and age on willingness to try cultured meat, and (2) the role of loss aversion as a mediating factor between regret and willingness to try cultured meat. The results demonstrate the effectiveness of regret appeal in increasing consumers' willingness to try cultured meat, particularly among older populations. This is because older populations exhibit higher levels of loss aversion. The present study is the first to shed light on the interactive effect of regret and age in influencing sustainable product acceptance. Furthermore, the study establishes the first empirical evidence to demonstrate that loss aversion is a valid self-regulating strategy adopted to cope with the feeling of regret in a consumption context.

Decision Regret and Decision-Making Process among Caregivers of Older Adults Receiving Home Care: A Cross-Sectional Study.

OBJECTIVES: Family caregivers of older adults receiving home care often find themselves in situations in which they must make important and difficult decisions, which can cause conflict and regret. To tailor shared decision making in this context, we aimed to identify the most difficult decisions they faced, assess their levels of decision regret, and explore the associated factors. DESIGN: This study used a cross-sectional design. SETTING AND PARTICIPANTS: Participants included 165 caregivers of older adults who received home care services in Korea. METHODS: We identified difficult decisions perceived by family caregivers of older adults and evaluated decision regret using the Decision Regret Scale (DRS), decisional conflict using the Decisional Conflict Scale (DCS), burden of care using the Short Zarit Burden Inventory, and Preference Control Scale (PCS). We then performed descriptive, bivariate, and multivariate linear regression analyses to identify factors predicting decision regret. RESULTS: The most frequently reported difficult decisions were related to place of living (71.6%), management of health conditions (15.1%), and end-of-life decisions (13.3%). The mean DCS score was 37.09 (12.67), the DRS score was 32.33 (15.91), and the burden score was 21.81 (8.25). Matching decisions with preferences and aligning decision-making roles significantly reduced regret, while decision conflicts increased regret. CONCLUSIONS AND IMPLICATIONS: The positive associations between decision regret, decision conflict, and the alignment of decision-making roles highlight the intricate dynamics involved in the decision-making process for family caregivers. These findings emphasize the need for tailored interventions that recognize and address the diverse factors influencing caregivers' decision-making experiences. Future research exploring the efficacy of targeted interventions such as decision-support programs or caregiver education initiatives could offer valuable insights into mitigating decision-related challenges and improving the overall well-being of both caregivers and care recipients.

Thompson Sampling for Stochastic Bandits with Noisy Contexts: An Information-Theoretic Regret Analysis.

We study stochastic linear contextual bandits (CB) where the agent observes a noisy version of the true context through a noise channel with unknown channel parameters. Our objective is to design an action policy that can "approximate" that of a Bayesian oracle that has access to the reward model and the noise channel parameter. We introduce a modified Thompson sampling algorithm and analyze its Bayesian cumulative regret with respect to the oracle action policy via information-theoretic tools. For Gaussian bandits with Gaussian context noise, our information-theoretic analysis shows that under certain conditions on the prior variance, the Bayesian cumulative regret scales as O˜(mT), where m is the dimension of the feature vector and T is the time horizon. We also consider the problem setting where the agent observes the true context with some delay after receiving the reward, and show that delayed true contexts lead to lower regret. Finally, we empirically demonstrate the performance of the proposed algorithms against baselines.

"As Long as There's a Glimmer of Hope, I'm Willing to Try": The Moral Experiences of Parental Pursuit for Autism Therapy in Urban China.

In today's China, countless parents embark on a journey of moral peril in search of treatment for their children with autism, navigating a bustling yet chaotic market of therapies. Based on 13 months of fieldwork in the Pearl River Delta, this study examines how the boom of China's autism therapy industry has plunged parents, who are relentlessly striving for their children's futures, into deeper vulnerability. I view the "ethics of trying" as parental enactment of their moral agency in seeking therapy and reveal how it serves as a moral engine for the industry's growth in the early 21st century, as well as how it leads to moral tragedies for parents as new norms of therapeutic choice emerge with government and professional guidance compelling them to make optimal therapeutic choices within a critical developmental window. Although parental efforts to avoid "agent-regret" can paradoxically lead to significant remorse, the moral tragedy they encounter can also prompt reflection and reevaluation of their approach to their child's condition.

Effectiveness of patient decision aids in patients with advanced kidney disease: a meta-analysis based on randomized controlled trials.

PURPOSE: To systematically evaluate the decision effectiveness of patient decision aids (PtDAs) on the decision-making effect of patients with advanced chronic kidney disease. METHOD: Two authors independently searched ten electronic databases [Web of science, PubMed, the Cochrane Library, Embase, CINAHL, EBSCO, CBM, CNKI, WanFang DATA and Vip database], to include randomized controlled trials of interventions through PtDAs in patients with advanced chronic kidney disease published from the inception of the database until April 2024. Two authors conducted a comprehensive quality evaluation (Cochrane 5.1.0) before independently extracting and analyzing the data with RevMan 5.2. RESULTS: The study included 11 randomized controlled trials with a total of 1613 patients. According to the results, PtDAs can improve the decision knowledge [SMD = 0.53, 95% CI (0.26, 0.80), P = 0.0002] and decision preparation [SMD = 2.34, 95% CI (2.04, 2.65), P < 0.00001] of patients with advanced chronic kidney disease. Additionally, there was a substantial decrease in the levels of decision regret [SMD = - 1.33, 95% CI (- 2.11, - 0.55), P < 0.05] and decision conflict [SMD = - 0.88, 95% CI (- 1.47, - 0.28), P = 0.004]. CONCLUSION: The current available evidence indicates that PtDAs can significantly enhance the decision knowledge and decision preparation of patients with advanced chronic kidney disease. Additionally, PtDAs can reduce the levels of decision regret and decision conflict. TRIAL REGISTRY: CRD42023433798.

Reining in regret: emotion regulation modulates regret in decision making.

Whereas the influence of regret on decision making is well-established, it remains unclear whether emotion regulation may modulate both the affective experience of regret and its influence on decisions. To examine this question, participants made decisions about options involving uncertainty using two different, instructed emotion regulation strategies. In one case, they were instructed to treat each choice individually, while in the other they were encouraged to treat a series of decisions as a portfolio. The present experiment demonstrates that approaching a series of decisions as a portfolio led to less extreme affective reactions to outcomes and lowered physiological arousal levels compared to focusing on each decision in isolation. However, the different emotion regulation strategies did not alter the influence of anticipatory regret on choices. The results indicate that these different emotion regulation strategies can be used to alter the experience of regret. These findings support a role for cognitive strategies in mitigating the affective experience of regret and suggest a means to encourage consumer welfare.

A novel Hellinger distance-based regret theory method for spherical fuzzy decision making model and its application in logistics.

Actual decision making problems are often based on the company decision maker's behavior factors, such as risk attitude, subjective preference, etc. Regret theory can well express the behavior of the decision maker. In this pursuit, a novel decision making method was developed, based on the regret theory for the multi-attribute decision making problem, in which attribute values were expressed by spherical fuzzy numbers. Distance measurement not only has extensive applications in fields such as pattern recognition and image processing, but also plays an important role in the research of fuzzy decision theory. The existing distance measures of spherical fuzzy set either have special cases of anti-intuition or are more complex in calculation, so finding suitable distance measures is also an important research topic in the decision-making theory of spherical fuzzy set. For this reason, we first establish a new distance of spherical fuzzy sets based on Hellinger distance of probability distribution. A decision maker's perception utility value function is proposed using the new distance formula, which is used to measure the regretful and rejoice value. Then we establish an optimization model for solving the attribute weights, when the information of attribute weight was partially known. Subsequently, the comprehensive perceived utility values were utilized to rank the order of the alternatives. Finally, a numerical example of assessment of logistics providers is used to show that the new decision making method is effective and feasible.

Decision regret after prostate biopsy for prostate cancer diagnosis: a Korean multicenter cohort study.

BACKGROUND: Many people struggle with the choice in a series of processes, from prostate cancer (PCa) diagnosis to treatment. We investigated the degree of regret after the prostate biopsy (PBx) and relevant factors in patients recommended for biopsy for suspected PCa. METHODS: From 06/2020 to 05/2022, 198 people who performed PBx at three institutions were enrolled and analyzed through a questionnaire before and after biopsy. Before the biopsy, a questionnaire was conducted to evaluate the sociodemographic information, anxiety scale, and health literacy, and after PBx, another questionnaire was conducted to evaluate the decision regret scale. For patients diagnosed as PCa after biopsy, a questionnaire was conducted when additional tests were performed at PCa staging work-up. RESULTS: 190 patients answered the questionnaire before and after PBx. The mean age was 66.2 ± 7.8 years. Overall, 5.5% of men regretted biopsy, but there was no significant difference between groups according to the PCa presence. Multivariate analysis, to identify predictors for regret, revealed that the case when physicians did not properly explain what the prostate-specific antigen (PSA) test was like and what PSA elevation means (OR 20.57, [95% CI 2.45-172.70], p = 0.005), low media literacy (OR 10.01, [95% CI 1.09-92.29], p = 0.042), and when nobody to rely on (OR 8.49, [95% CI 1.66-43.34], p = 0.010) were significantly related. CONCLUSIONS: Overall regret related to PBx was low. Decision regret was more significantly related to media literacy rather than to educational level. For patients with relatively low media literacy and fewer people to rely on in case of serious diseases, more careful attention and counseling on PBx, including a well-informed explanation on PSA test, is helpful.

A generalized interval-valued p,q Rung orthopair fuzzy Maclaurin symmetric mean and modified regret theory based sustainable supplier selection method.

A novel interval valued p,q Rung orthopair fuzzy (IVPQ-ROF) multiple attribute group decision making (MAGDM) method for sustainable supplier selection (SSS) is proposed in this paper. This study mainly contains two research points: (1) tackling the interrelation between attributes; and (2) describing the psychological state and risk attitude of decision makers (DMs). For the first research point, we introduce the Archimedean operation rules for interval valued p,q Rung orthopair fuzzy sets (IVPQ-ROFSs), then the generalized interval valued p, q Rung orthopair fuzzy Maclaurin symmetric mean (GIVPQ-ROFMSM) operator and the generalized interval valued p, q Rung orthopair fuzzy weighted Maclaurin symmetric mean (GIVPQ-ROFWMSM) operator are defined to reflect the correlation between attributes. For the second research point, we introduce the positive ideal degree (PID) and negative ideal degree (NID) based on projection of IVPQ-ROFSs, and modified regret theory. Both of them consider the best alternative and worst alternative, so as to reflect the psychological state and risk attitude of DMs. Finally, a SSS problem is presented to manifest the effectiveness of the designed method. We also provide sensitivity analysis and comparative analysis to further demonstrate the rationality and validity of the proposed method.

Permanent makeup: A review of its technique, regulation, and complications.

Permanent makeup (PMU) is a popular form of tattooing used to replace or enhance the use of daily makeup. The purpose of this literature review is to provide an overview of PMU, with a particular focus on its use, regulation, and potential complications reported in the literature. In the United States, there is significant variation in the regulation and training required to perform PMU. Adverse outcomes of PMU include infectious, allergic, and inflammatory complications. These complications may be more common if proper hygiene and aftercare practices are not followed. Cosmetically, PMU may shift or have an altered appearance if the underlying skin is treated with cosmetic fillers or local anesthetics. Given the popularity of PMU and its cosmetic uses, dermatologists should be aware of the PMU industry, potential complications, and how best to manage complications.

Sexual and couple outcomes of vasectomy: Results of a French questionnaire survey.

INTRODUCTION: Vasectomy is a permanent contraceptive method that is increasingly appealing to French men with diverse patient profiles. An important question is the impact on sexual life. We aimed to specify the profile of men seeking vasectomy and its impact on their lives. METHOD: Based on a consecutive series of 446 men undergoing vasectomy at a university center between April 2010 and March 2022, an online survey was launched in April 2022. In total, 177 patients responded to the questionnaire. The median time between surgery and questionnaire response was 33months (15, 50). At the time of vasectomy, the main age group was 36-45years (55%). RESULTS: The reflection period before consultation exceeded 1year for 69%. At the time of surgery, only 8% of men were single and 18% were childless. Vasectomy was a couple's decision in 45% of cases. The main motivation was the shift in contraceptive burden for 76% of patients. Harmony in the couple was unchanged for 58% and improved for 33%. Libido remained stable for 79% and improved for 13%; 97% of men reported being satisfied with having undergone vasectomy; 96% had no regrets about surgery; 98% never considered having corrective surgery, and 99% never had a childbearing plan after the intervention. CONCLUSION: Men increasingly share contraceptive burden. Vasectomy has no significant deleterious impact on sexual life. Satisfaction is high, and the vast majority of men undergoing vasectomy have no regret of their decision. Consequently, vasectomy should continue to expand in France.

A novel integration of regret-based methodology and bankruptcy theory for waste load allocation.

Developing a suitable index for Waste Load Allocation (WLA) is essential for both industrial polluters and environmental organizations. Identifying the index that best describes the quality conditions of the river is the main concern of this study. To achieve this purpose, a novel framework incorporating a regret-based index and a bankruptcy-based approach to address the impacts of low water quality and pollutant locations within the WLA are introduced. The framework includes a simulation-optimization model to minimize river quality regret for environmental organizations and total treatment cost for industrial polluters, employing Nash bargaining theory for conflict resolution. Additionally, a new bankruptcy approach, the Namin's rule, is proposed for redistributing the River Quality Regret Index among industrial polluters. Applying this methodology to data from the KhoramAbad River, a sensitivity analysis reveals that while there is no significant difference between the methodology and fuzzy risk when polluters are close, the methodology provides more accurate results as the distance between polluters increases. When the distance between two pollutants was 20 km, the sum of WLA was evaluated to be 300 kg per day higher than that in the compared method, potentially enhancing environmental justice.

Determinants of Decision Regret Regarding Fertility Preservation in Adolescent and Young Adult Cancer Survivors: A Systematic Review.

Given recent advances in cancer therapeutics, there is a growing population of adolescent and young adult (AYA) cancer survivors navigating the physical and psychological consequences of cancer treatment. Fertility preservation (FP) conversations are of increasing importance for these survivors. Decision regret (DR) is a measure of distress or remorse following a health care decision, and it is a useful tool to evaluate the impact of a treatment on quality of life. The aim of this systematic review is to culminate existing literature focused on determinants of FP DR among AYA cancer survivors and to propose future interventions to reduce DR among AYA cancer survivors. An electronic database search was performed using PubMed, Web of Science, and APA PsycINFO for articles published before December 2023 using the following search criteria: PubMed: "Fertility Preservation"[Mesh] AND decision regret, APA PsycINFO and Web of Science: Fertility Preservation AND decision regret. Articles were organized into five categories that emerged after initial review. Nineteen articles that focused on DR and FP in AYA cancer survivors aged ≤40 and ≥12 years were included. Article results were categorized into five categories pertaining to determinants of FP DR: Unmet Informational and Emotional Needs, Need for Developmentally Appropriate Conversations, Insufficiency of Provider Training, Quality and Timeliness of Fertility Preservation Discussions, and Societal Barriers. These results highlight the need for improved patient and provider education on FP, such as future longitudinal studies focused on standardization of FP-related protocols and the impact of their implementation on DR, especially for AYA cancer survivors.

Patient-related decisional regret: An evolutionary concept analysis.

BACKGROUND: Health-related decision-making is a complex process given the variability of treatment options, conflicting treatment plans, time constraints and variable outcomes. This complexity may result in patients experiencing decisional regret following decision-making. Nonetheless, literature on decisional regret in the healthcare context indicates inconsistent characterization and operationalization of this concept. AIM(S): To conceptually define the phenomenon of decisional regret and synthesize the state of science on patients' experiences with decisional regret. DESIGN: A concept analysis. METHODS: Rodgers' evolutionary method guided the conceptualization of this review. An interdisciplinary literature search was conducted from 2003 until 2023 using five databases, PubMed, CINAHL, Embase, PsycINFO and Web of Science. The search informed how the concept manifested across health-related literature. We used PRISMA-ScR checklist to guide the reporting of this review. RESULTS: Based on the analysis of 25 included articles, a conceptual definition of decisional regret was proposed. Three defining attributes underscored the negative cognitive-emotional nature of this concept, post-decisional experience relating to the decision-making process, treatment option and/or treatment outcome and an immediate or delayed occurrence. Antecedents preceding decisional regret comprised initial psychological or emotional status, sociodemographic determinants, impaired decision-making process, role regret, conflicting treatment plans and adverse treatment outcomes. Consequences of this concept included positive and negative outcomes influencing quality of life, health expectations, patient-provider relationship and healthcare experience appraisal. A conceptual model was developed to summarize the concept's characteristics. CONCLUSION: The current knowledge on decisional regret is expected to evolve with further exploration of this concept, particularly for the temporal dimension of regret experience. This review identified research, clinical and policy gaps informing our nursing recommendations for the concept's evolution. NO PATIENT OR PUBLIC CONTRIBUTION: This concept analysis examines existing literature and does not require patient-related data collection. The methodological approach does not necessitate collaboration with the public.

Patient-reported outcomes after oral cancer reconstructions with radial and ulnar forearm-free flaps.

OBJECTIVES: This study aimed to evaluate patient-reported quality of life and incidence of decision regret in patients undergoing radial (RFFF) and ulnar forearm-free flaps (UFFF) reconstruction. MATERIALS AND METHODS: Patients undergoing either RFFF or UFFF were assessed with the University of Washington Quality of Life (UW-QOL) and Oral Health Impact Profile (OHIP-14) questionnaires, and the Decision Regret Scale (DRS), both before and at least 12 months post-reconstruction. RESULTS: In total, 40 RFFF and 40 UFFF were included. Harvesting time was longer in RFFF (p = 0.043), and the donor-site defect was significantly larger in RFFF than in UFFF (p = 0.044). Patients with UFFF scored better UW-QOL in the appearance, pain, activity, mood, and social functioning domains (p < 0.05). However, the RFFF group excelled in swallowing and chewing domains. The DRS score revealed a significant difference between RFFF and UFFF, with scores of 36.26 versus 27.36, respectively. Moreover, the mean DRS score reduced at 12 months compared with 6 months, significantly superior for UFFF. CONCLUSION: Oral cancer patients reconstructed with UFFF exhibited a better appearance, social domain, and mild decision regret compared with RFFF, indicating that the UFFF may contribute to improving postoperative quality of life in oral cancer patients.