PubMed Health⌕ Search

Biomedical subjects

Richard Fuller

Publications and source records attributed to Richard Fuller.

6 recordsLinked to original sources
PubMed2004

Avoidance hierarchies and preferences for anticoagulation--semi-qualitative analysis of older patients' views about stroke prevention and the use of warfarin.

OBJECTIVE: To examine older patients' preferences regarding the use of warfarin to prevent atrial fibrillation related strokes when faced with cumulative probabilities of treatment risk and benefit. DESIGN: A semi-qualitative researcher administered questionnaire and interview. SUBJECTS: 81 patients attending a general elderly medicine outpatient clinic. RESULTS: Up to 50% of participants would decline warfarin treatment when shown both cumulative benefits of stroke risk reduction and risk of intracerebral haemorrhage. Principal themes highlighted concepts of gambling and trade offs relating to risk and benefit. Attitudes about stroke and negative perceptions of intracerebral haemorrhage were major contributory themes in the decision to refuse warfarin treatment. CONCLUSION: Older people use very individualistic health beliefs in judging how to trade risks to preserve quality of life. Carefully explaining risk information and listening to elders' views and reasoning is likely to result in a more informed choice regarding the use of anticoagulation in stroke prevention.

Aged↗
PubMed2004

Managing health risks: junior doctors' views of risk and decision making.

Managing risk and making decisions presents an increasing challenge to doctors as they are encouraged to adopt a partnership approach with patients to dealing with risk, within a "risk society" constructed around individuality, uncertainty, blame and responsibility. In-depth interviews, stimulated by clinical vignettes, were used to explore the key position of doctors within this risk society. Analysis, sensitised through contemporary texts, revealed unexpected findings that portrayed doctors as reflexive jugglers of risk. Discourses in this study revealed indecision and uncertainty, balanced against needs to preserve professional roles and engage patients in addressing risk, whilst preventing widespread harm and conflict. In concluding, the alternative approaches to risk with older people will suggest a more trusting and positive process that presents a real opportunity for truly sharing risk and decisions that benefit both doctor and patient.

Aged↗