Date of Submission

2013

Degree Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

Department Chair

Robert A DiTomasso, PhD, ABPP, Chair, Department of Psychology

First Advisor

Stephanie Felgoise, PhD, ABPP, Chairperson

Second Advisor

Victoria L Vetter, MD

Third Advisor

Barbara Golden, PsyD, ABPP

Abstract

Physicians are faced with ongoing challenges in diagnosing long QT syndrome (LQTS) and the uncertainty regarding treatment for specific genotypes and prescription of restrictions regarding physical activity. This study explored what impacts physicians’ decision making with regard to treatment and recommendations for children and adolescents with LQTS. Semi-structured interviews were conducted with pediatric cardiologists who were currently treating this population. Several themes regarding physician decision making were identified: constant reevaluation of decisions, impact of years of experience/number of LQTS patients treated, differentiating from versus joining with other physicians, variations in recommending patient sports involvement and activity level, and physicians as recommenders versus decision makers. The findings emphasize the importance of physicians considering the biopsychosocial implications of their decisions on patients during the decision-making process. Also, physicians should create open lines of communication and transparency regarding the roles of patients and parents in treatment decision making and foster feelings of competency in young patients to support their confidence in making medical decisions for themselves in the future.

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