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PubMed1988

Sterilization regret among Puerto Rican women.

This study examined sterilization regret among Puerto Rican women with contraceptive tubal sterilizations (TS) using retrospective data from a population-based survey of women aged 15 to 49 years. Twenty-one percent of the 846 respondents expressed some regret, with 11% stating definite dissatisfaction with the decision. Factors associated with regret were young age at TS, absence of daughters, someone else making the decision to be sterilized, medical indications for TS, sterilization failure, and living with a new marital partner. There were no significant effects associated with the timing of sterilization, whether interval or postpartum, or with the type of last delivery. Other factors not independently associated with regret included years since TS, parity, education, and age at follow-up.

Adolescent↗
PubMed1991

The pre- and poststerilization predictors of poststerilization regret in husbands and wives.

Husbands and wives from 141 tubal sterilization couples and 162 vasectomy couples were interviewed just prior to sterilization and then again 1 and 2 years later. We conducted linear regression analyses to determine the pre- and poststerilization predictors of poststerilization regret in each of the four gender x method groups (tubal husbands, tubal wives, vasectomy husbands, vasectomy wives). We confirmed a number of hypotheses based on the research literature and our own earlier work. Both individual and couple factors contributed to the development of regret, as did both pre- and poststerilization factors. An important finding was the degree to which regret among the nonsterilized respondents (tubal husbands, vasectomy wives) was affected by pre- and poststerilization interaction with their spouses.

Adult↗
PubMed1994

Incidence, risk factors, and prevention of poststerilization regret in women: an updated international review from an epidemiological perspective.

Tubal sterilization is the world's most commonly used contraceptive method. Even a small proportion of women incurring poststerilization regret would translate into a large number of sufferers. In this review, we examine recent reports on the incidence of, and the risk factors for, posttubal sterilization regret in women and requests for sterilization reversal in both developed countries and less-developed countries. We also consider the implications of our findings in the practical prevention of poststerilization regret and requests for sterilization reversal, and discuss methodological issues.

Adult↗
PubMed1996

Regret graphs, diagnostic uncertainty and Youden's Index.

Regret is the difference in outcome between the action we took and the best action we could, in retrospect, have taken. 'Tent graphs', representing decision problems under uncertainty in terms of expected regret, offer an instructive geometric supplement to standard formulae, allow instant calculations, and suggest, as we shall illustrate, novel algebraic properties. For instance, the problem of finding the pre-test probability range in which it is worthwhile doing a diagnostic test becomes trivial, even when test costs depend on the unknown disease status; we take the opportunity to explore the (non-trivial) algebraic properties of this problem. The graphs also provide a simple way to illustrate and read off the expected value of information and expected value of perfect information. This property is used to derive a clinical interpretation of Youden's Index (sensitivity + specificity - 1), namely, it is the maximum proportional reduction in expected regret achieved by the test. Finally, we examine the relationship between Youden's Index and the area under an ROC curve.

Aged↗
PubMed2000

Women's regrets after bilateral prophylactic mastectomy.

BACKGROUND: Primary prevention strategies such as chemopreventive agents (e.g., tamoxifen) and bilateral prophylactic mastectomy (PM) have received increasingly more attention as management options for women at high risk of developing breast cancer. METHODS: A total of 370 women, who had registered in the Memorial Sloan-Kettering Cancer Center National Prophylactic Mastectomy Registry, reported having undergone a bilateral PM. Twenty-one of these women expressed regrets about their decision to have a PM. A psychiatrist and psychologist interviewed 19 of the women about their experiences with the PM. RESULTS: A physician-initiated rather than patient-initiated discussion about the PM represented the most common factor in these women. Psychological distress and the unavailability of psychological and rehabilitative support throughout the process were the most commonly reported regrets. Additional regrets about the PM related to cosmesis, perceived difficulty of detecting breast cancer in the remaining breast tissue, surgical complications, residual pain, lack of education about the procedure, concerns about consequent body image, and sexual dysfunction. CONCLUSIONS: Although a PM statistically reduces the chances of a woman developing breast cancer, the possibility of significant physical and psychological sequelae remains. Careful evaluation, education, and support both before and after the procedure will potentially reduce the level of distress and dissatisfaction in these women. We discuss recommendations for the appropriate surgical and psychiatric evaluation of women who are considering a PM as risk-reducing surgery.

Adult↗
PubMed1992

Evaluation of regret after tubal sterilization.

Many different criteria and profiles have been suggested for the possible cause of regret and requests for reversal after tubal sterilization. Evaluation of data obtained from 2253 women who had undergone tubal sterilization showed a strong correlation between regrets and youthful age and to changes in marital situation. Previously demonstrated risk factors, such as sterilization in connection with abortion or labor were not related to regret in this study material.

Adult↗
PubMed1988

The objective evaluation of alternative treatment plans: I. Images of regret.

An innovative approach to treatment planning is described in which a planned dose distribution is evaluated in terms of prescribed limits of acceptability, and any discrepancies (referred to as "regions of regret") are displayed in the form of a contour diagram in which colors are used to represent different types and degrees of regret. A commercial treatment planning system has been modified to display images of regret in addition to conventional isodose plots, and is used for the comparison of alternative plans in terms of adequate target coverage and minimal irradiation of sensitive organs. Required tumor dose levels and organ-specific tolerance doses are prepared in advance by the clinician for each site and stored in a prescription file for use in the planning process. The method is found to expedite the optimization procedure, is objective and reproducible, and provides clear documentation of the selection process.

Computer Graphics↗
PubMed1994

Changing adolescents' sexual behaviour: perceived risk, self-efficacy and anticipated regret.

This article focuses on determinants of adolescent AIDS-related behaviour. First, we will focus on the perception of risk for AIDS and possible optimistic biases in perceived risk. The behavioural consequences of optimism or perceived invulnerability will be briefly discussed. Next, we will focus on other determinants of sexual risk behaviour, i.e. self-efficacy and anticipated regret. Gender differences in the predictive power of these factors will be discussed. Finally, we will summarize the results of a series of studies investigating the role of anticipated regret as a determinant of adolescent sexual risk behaviour. The possible contribution of stressing anticipated regret in prevention programs aiming adolescents to adopt safer sex practices will be discussed.

Acquired Immunodeficiency Syndrome↗
PubMed2026

Long-term outcomes of surgical correction of ventral penile curvature in children: Patient-reported measures, surgical results, and decisional regret.

INTRODUCTION: There is a dearth of data on long-term outcomes, including patient-reported outcomes (PROMs), decisional regret, and complication rates for surgical correction of isolated ventral penile curvature in childhood. PATIENTS AND METHODS: Twenty-six children treated for ventral curvature between 1993 and 2008 were identified; 24 met inclusion criteria (isolated ventral curvature without hypospadias or need for urethral reconstruction). Surgical correction consisted of degloving alone or degloving with Nesbit-like dorsal plication when residual curvature >20° persisted after degloving. PROMs were collected via pre-mailed validated questionnaires after puberty: Danish Prostatic Symptom Score (DAN-PSS) for LUTS, Erection Hardness Score (EHS) for erectile function, Penile Perception Score (PPS) for cosmetic perception, and items assessing decisional regret and perceived appropriateness of surgical timing. RESULTS: Curvature was corrected intraoperatively in all 24 patients. Twelve underwent degloving alone and 12 required additional dorsal plication. During long-term follow-up (median 14.2 years), one patient (4%) underwent re-operation for residual curvature, and three (13%) underwent cosmetic revisions; two (8%) underwent cystoscopy for flow concerns. 71% returned PROMs at a median age of 16.2 years. LUTS were uncommon, with low bother scores. Erectile function was favorable: 87% (13/15) reported EHS 4 and 93% (14/15) reported ejaculation. Cosmetic outcomes were favorable, with PPS dissatisfaction rates comparable to controls. Two patients reported dissatisfaction with overall appearance, and one with residual subjective curvature. No patient expressed decisional regret, and 88% felt timing of surgery was appropriate. CONCLUSION: Early surgical correction of isolated ventral penile curvature using degloving with or without dorsal plication provided durable anatomical correction and favorable long-term functional and cosmetic outcomes. These findings support early intervention as an effective approach with sustained patient-perceived benefits.

Humans↗
PubMed2006

Minimax regret optimization analysis for a regional solid waste management system.

Solid waste management (SWM) facilities are crucial for environmental management and public health in urban regions. Due to the waste management hierarchy, one of the greatest challenges that organizations face today is to figure out how to diversify the treatment options, increase the reliability of infrastructure systems, and leverage the redistribution of waste streams among incineration, compost, recycling, and other facilities to their competitive advantage region wide. Systems analysis plays an important role for regionalization assessment of integrated SWM systems, leading to provide decision makers with break-through insights and risk-informed strategies. This paper aims to apply a minimax regret optimization analysis for improving SWM strategies in the Lower Rio Grande Valley (LRGV), an economically fast growing region in the US. Based on different environmental, economic, legal, and social conditions, event-based simulation in the first stage links estimated waste streams in major cities in LRGV with possible solid waste management alternatives. The optimization analysis in the second stage emphasizes the trade-offs and associated regret evaluation with respect to predetermined scenarios. Such optimization analyses with multiple criteria have featured notable successes, either by public or private efforts, in diverting recyclables, green waste, yard waste, and biosolids from the municipal solid waste streams to upcoming waste-to-energy, composting, and recycling facilities. Model outputs may link prescribed regret scenarios in decision making with various scales of regionalization policies. The insights drawn from the system-oriented, forward-looking, and preventative study can eventually help decision-makers and stakeholders gain a scientific understanding of the consequences of short-term and long-term decisions relating to sustainable SWM in the fast-growing US-Mexico borderland.

Conservation of Natural Resources↗
PubMed2000

Correlates of female sterilization regret in the southern states of India.

This study analyses factors associated with the incidence of sterilization regret in the four south Indian states of Andhra Pradesh, Karnataka, Kerala and Tamil Nadu. Using data from the National Family Health Surveys, in all four states the incidence of regret was found to be less than 10% and the factors significantly associated with it were child loss experience and quality of services. Hence, there is a need to improve the quality of services, both in terms of counselling and service provision, and women need to be counselled about the permanent nature of sterilization in order to avoid future regret.

Adult↗
PubMed2004

Anatomy of regret: a developmental view of the depressive position and a critical turn toward love and creativity in the transforming schizoid personality.

This article deals with critical psychic transformation in a schizoid personality disorder that evolves in an object relations psychoanalysis in which "developmental mourning" plays a central role. Within a mourning process that allows for the grieving of loss related to arrested separation-individuation development, the analysand confronts the existential grief of regret that had always unconsciously haunted her. The unconscious guilt related to the existential grief of regret had caused much dissociation of self-experience and affect states. The analysand acknowledges her own part in the destruction of primal and current relationships after the traumatic impact of her early life is understood. This allows her to repair current relationships, both within her internal and external worlds so that she can open to capacities for love and creativity. The analysand's courage to consciously grapple with her regret (loss and guilt combined) allows her to relinquish self-sabotaging character defenses such as contempt and emotional withdrawl. Consequently, a second marriage is salvaged and enriched, and the analysand's relationship with her two children is dramatically improved.

Adult↗
PubMed2001

The additional value of anticipated regret and psychopathology in explaining intended condom use among drug users.

Abstract In this study we examine determinants of intended condom use with casual and steady sex partners among drug users. Our aim was to find out whether anticipated regret and psychopathology represent additional factors in explaining condom use behaviour, on top of the constructs defined in traditional psychosocial models of behaviour. A questionnaire measuring intentions, attitude, beliefs, personal norm, subjective norm, descriptive norm, self-efficacy and anticipated regret toward condom use with steady and casual sex partners, and the Symptom Checklist '90 (to measure dimensions of psychopathology) were handed out to 150 Dutch drug users. The results showed that intended condom use with steady sex partners was mainly predicted by self-efficacy, personal norm and anticipated regret (total R2 = 0.41). Lower feelings of hostility and a more positive personal norm, subjective norm and attitude significantly predicted intended condom use with casual sex partners (total R2 = 0.24). The results also showed that intended condom use with steady sex partners seems to result from anticipating possible barriers, whereas condom use with casual sex partners is largely a matter of having safe sex norms. Practical implications of this study for Aids-preventive campaigns are also discussed.

Condoms↗
PubMed2006

Minimax regret analysis for municipal solid waste management: an interval-stochastic programming approach.

In this study, an interval minimax regret programming (IMMRP) method is developed for the planning of municipal solid waste (MSW) management under uncertainty. It improves on the existing interval programming and minimax regret analysis methods by allowing uncertainties presented as both intervals and random variables to be effectively communicated into the optimization process. The IMMRP can account for economic consequences under all possible scenarios without any assumption on their probabilities. The developed method is applied to a case study of long-term MSW management planning under uncertainty. Multiple scenarios associated with different cost and risk levels are analyzed. Reasonable solutions are generated, demonstrating complex tradeoffs among system cost, regret level, and system-failure risk. The method can also facilitate examination of the difference between the cost incurred with identified strategy and the least cost under an ideal condition. The results can help determine desired plans and policies for waste management under a variety of uncertainties.

Costs and Cost Analysis↗
PubMed2006

Conformism moderates the relations between values, anticipated regret, and behavior.

The purpose of the present study was to evaluate the moderating effect of Conformism values on the relations between other values and behavior. The authors expected people low, but not high, in Conformism to behave in a manner that is consistent with their personal values related to self-transcendence versus self-enhancement. In Study 1 (N = 199), such values predicted actual altruistic behavior, as estimated by other-reports, but only if Conformism values were low. In Study 2 (N = 189), only people who considered Conformism values to be relatively unimportant showed expected connections between self-transcendence values and anticipated regret in hypothetical scenarios having negative consequences. The data are interpreted as supporting the view that (a) anticipated regret motivates value-consistent behavior, (b) self-transcendence values in particular are connected to altruistic behavior and to anticipated regret, but (c) conformity to social norms moderates these connections.

Adult↗
PubMedDate not supplied

An international comparison of physicians' judgments of outcome rates of cardiac procedures and attitudes toward risk, uncertainty, justifiability, and regret.

OBJECTIVE: Compare U.K. and U.S. physicians' judgments of population probabilities of important outcomes of invasive cardiac procedures; and values held by them about risk, uncertainty, regret, and justifiability relevant to utilization of cardiac treatments. DESIGN: Cross-sectional study. SETTING: University hospital and VA medical center in the United States; two teaching hospitals in the United Kingdom. PARTICIPANTS: 171 housestaff and attendings at U.S. teaching hospitals; 51 physician trainees and consultants at U.K. hospitals. MEASURES: Judgments of probabilities of severe complications and deaths due to Swan-Ganz catheterization, cardiac catheterization, percutaneous transluminal coronary angioplasty (PTCA), and coronary artery bypass grafting (CABG); judgments of malpractice risks for case vignettes; Nightingale's risk-aversion instrument; Gerrity's reaction-to-uncertainty instrument; questions about need to justify decisions; responses to case vignettes regarding regret. RESULTS: The U.S. physicians judged rates of two bad outcomes of cardiac procedures (complications due to cardiac catheterization; death due to CABG) to be significantly higher (p < or = 0.01) than did the U.K. physicians (U.S. medians, 5 and 3.5, respectively; U.K. medians 3 and 2). The median ratio of (risk of malpractice suit I error of omission)/(risk of suit I error of commission) judged by U.K. physicians, 3, was significantly (p=0.0006) higher than that judged by U.S. physicians, 1.5. The U.K. physicians were less often risk-seeking in the context of possible losses than the U.S. physicians (odds ratio for practicing in the U.K. as a predictor of risk seeking 0.3, p=0.003). The U.K. physicians had significantly more discomfort with uncertainty than did the U.S. physicians, as reflected by higher scores on the stress scale (U.K. median 48, U.S. 42, p=0.0001) and the reluctance-to-disclose-uncertainty scale (U.K. 40, U.S. 37, p < 0.0001) of the Gerrity instrument. There was no clear international difference in perceived need to justify decisions, or in regret. CONCLUSIONS: The results were not clearly consistent with the uncertainty hypothesis that international practice variation is due to differences in judged rates of outcomes of therapy or with the imperfect-agency hypothesis that practice variation is due to differences in physicians' personal values. The causes and implications of practice variations remain unclear.

Angioplasty, Balloon, Coronary↗
PubMed2005

Reminiscence, regrets and activity in older people in residential care: associations with psychological health.

BACKGROUND: Claims have been made of the benefits of reminiscence for older people's psychological health. The study reported here set out to determine whether measures of reminiscence, regrets, and activity participation would be associated with psychological health in older people, when age, dependency, self-reported health, and social well-being were controlled. DESIGN: Cross-sectional interview-based questionnaire survey. METHODS: Older people living in residential and nursing homes (N = 142) completed questionnaires that determined current levels of reminiscence, activity participation, and psychological health, while care staff recorded the participants' observed affect over the previous 2-week period. RESULTS: Multivariate analyses showed significant associations between reminiscence frequency, reminiscence enjoyment, and regrets, and psychological health outcomes, while controlling for age, dependency, self-reported health, and social well-being. While reminiscence enjoyment was associated with positive psychological health, high frequency of reminiscence and the presence of regrets were associated with negative psychological health. CONCLUSIONS: The study findings are discussed with reference to Eriksonian theory, reminiscence functions, and the potential for reminiscence in psychological therapy for older people.

Aged↗
PubMed2001

To do or not to do: desirability and consistency mediate judgements of regret.

In 4 studies, the authors demonstrated that when errors associated with action were inconsistent with decision nakers' orientation, they were undesirable and produced more regret than did errors associated with inaction. Conversely, when errors associated with action were consistent with decision makers' orientation. they were desirable and produced less regret than did errors associated with inaction. Desirability and consistency mediated this relationship, independent of mutability. These results were obtained when judgments and decisions to act or not act were made in close temporal proximity to one another as well as when participants reflected on their past decisions. The authors provide an analysis of when counterfactuals would and would not be expected to mediate judgments of normality and regret.

Adult↗