View in EDS HTML Full Text PDF Full Text

A qualitative analysis of responses to a question prompt list and prognosis and end-of-life care discussion prompts delivered in a communication support program.

Saved in:
Bibliographic Details
Title: A qualitative analysis of responses to a question prompt list and prognosis and end-of-life care discussion prompts delivered in a communication support program.
Authors: Walczak, Adam, Henselmans, Inge, Tattersall, Martin H. N., Clayton, Josephine M., Davidson, Patricia M., Young, Jane, Bellemore, Frances A., Epstein, Ronald M., Butow, Phyllis N.
Source: Psycho-Oncology. Mar2015, Vol. 24 Issue 3, p287-293. 7p. 1 Chart.
Subjects: Terminal care, Medical communication, Psychology of nurses, Psychology of caregivers, Medical decision making, Life expectancy, Health planning
Geographic Terms: Sydney (N.S.W.)
Abstract: Objective: Discussing end-of-life (EOL) care is challenging when death is not imminent, contributing to poor decision-making and EOL quality-of-life. A communication support program (CSP) targeting these issues may facilitate discussions. We aimed to qualitatively explore responses to a nurse-led CSP, incorporating a question prompt list (QPL—booklet of questions patients/caregivers can ask clinicians), promoting life expectancy and EOL-care discussions. Methods: Participants met a nurse-facilitator to explore an EOL-focussed QPL. Prognosis and advance care planning (ACP) QPL content was highlighted. Thirty-one transcribed meetings were analysed using thematic text analysis before reaching data saturation. Results: Thirty-one advanced cancer patients (life expectancy <12 months) and 11 family caregivers were recruited from six medical oncology clinics in Sydney, Australia. Intent to use the QPL related to information needs, involvement in care and readiness to discuss EOL issues. Many participants did not want life expectancy estimates, citing unreliable estimates, unknown treatment outcomes, or coping by not looking ahead. Most displayed interest in ACP, often motivated by a loved one's EOL experiences, clear treatment preferences, concerns about caregivers or recognition that ACP is valuable regardless of life expectancy. Timing emerged as a reason not to discuss EOL issues; many maintaining it was too early. Conclusion: Patients and caregivers appear ambivalent about acknowledging approaching death by discussing life expectancy but value ACP. Given heterogeneity in responses, individualised approaches are required to guide EOL discussion conduct and content. Further exploration of the role of prognostic discussion in ACP is warranted. [ABSTRACT FROM AUTHOR]
Copyright of Psycho-Oncology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
Full text is not displayed to guests.
FullText Links:
  – Type: pdflink
Text:
  Availability: 1
Header DbId: pbh
DbLabel: Psychology and Behavioral Sciences Collection
An: 102181765
AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: A qualitative analysis of responses to a question prompt list and prognosis and end-of-life care discussion prompts delivered in a communication support program.
– Name: Author
  Label: Authors
  Group: Au
  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Walczak%2C+Adam%22&quot;&gt;Walczak, Adam&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Henselmans%2C+Inge%22&quot;&gt;Henselmans, Inge&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Tattersall%2C+Martin+H%2E+N%2E%22&quot;&gt;Tattersall, Martin H. N.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Clayton%2C+Josephine+M%2E%22&quot;&gt;Clayton, Josephine M.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Davidson%2C+Patricia+M%2E%22&quot;&gt;Davidson, Patricia M.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Young%2C+Jane%22&quot;&gt;Young, Jane&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Bellemore%2C+Frances+A%2E%22&quot;&gt;Bellemore, Frances A.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Epstein%2C+Ronald+M%2E%22&quot;&gt;Epstein, Ronald M.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Butow%2C+Phyllis+N%2E%22&quot;&gt;Butow, Phyllis N.&lt;/searchLink&gt;
– Name: TitleSource
  Label: Source
  Group: Src
  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Psycho-Oncology%22&quot;&gt;Psycho-Oncology&lt;/searchLink&gt;. Mar2015, Vol. 24 Issue 3, p287-293. 7p. 1 Chart.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Terminal+care%22&quot;&gt;Terminal care&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Medical+communication%22&quot;&gt;Medical communication&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Psychology+of+nurses%22&quot;&gt;Psychology of nurses&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Psychology+of+caregivers%22&quot;&gt;Psychology of caregivers&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Medical+decision+making%22&quot;&gt;Medical decision making&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Life+expectancy%22&quot;&gt;Life expectancy&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Health+planning%22&quot;&gt;Health planning&lt;/searchLink&gt;
– Name: SubjectGeographic
  Label: Geographic Terms
  Group: Su
  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Sydney+%28N%2ES%2EW%2E%29%22&quot;&gt;Sydney (N.S.W.)&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: Discussing end-of-life (EOL) care is challenging when death is not imminent, contributing to poor decision-making and EOL quality-of-life. A communication support program (CSP) targeting these issues may facilitate discussions. We aimed to qualitatively explore responses to a nurse-led CSP, incorporating a question prompt list (QPL—booklet of questions patients/caregivers can ask clinicians), promoting life expectancy and EOL-care discussions. Methods: Participants met a nurse-facilitator to explore an EOL-focussed QPL. Prognosis and advance care planning (ACP) QPL content was highlighted. Thirty-one transcribed meetings were analysed using thematic text analysis before reaching data saturation. Results: Thirty-one advanced cancer patients (life expectancy &lt;12 months) and 11 family caregivers were recruited from six medical oncology clinics in Sydney, Australia. Intent to use the QPL related to information needs, involvement in care and readiness to discuss EOL issues. Many participants did not want life expectancy estimates, citing unreliable estimates, unknown treatment outcomes, or coping by not looking ahead. Most displayed interest in ACP, often motivated by a loved one&#39;s EOL experiences, clear treatment preferences, concerns about caregivers or recognition that ACP is valuable regardless of life expectancy. Timing emerged as a reason not to discuss EOL issues; many maintaining it was too early. Conclusion: Patients and caregivers appear ambivalent about acknowledging approaching death by discussing life expectancy but value ACP. Given heterogeneity in responses, individualised approaches are required to guide EOL discussion conduct and content. Further exploration of the role of prognostic discussion in ACP is warranted. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: &lt;i&gt;Copyright of Psycho-Oncology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=102181765
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1002/pon.3635
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 7
        StartPage: 287
    Subjects:
      – SubjectFull: Terminal care
        Type: general
      – SubjectFull: Medical communication
        Type: general
      – SubjectFull: Psychology of nurses
        Type: general
      – SubjectFull: Psychology of caregivers
        Type: general
      – SubjectFull: Medical decision making
        Type: general
      – SubjectFull: Life expectancy
        Type: general
      – SubjectFull: Health planning
        Type: general
      – SubjectFull: Sydney (N.S.W.)
        Type: general
    Titles:
      – TitleFull: A qualitative analysis of responses to a question prompt list and prognosis and end-of-life care discussion prompts delivered in a communication support program.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Walczak, Adam
      – PersonEntity:
          Name:
            NameFull: Henselmans, Inge
      – PersonEntity:
          Name:
            NameFull: Tattersall, Martin H. N.
      – PersonEntity:
          Name:
            NameFull: Clayton, Josephine M.
      – PersonEntity:
          Name:
            NameFull: Davidson, Patricia M.
      – PersonEntity:
          Name:
            NameFull: Young, Jane
      – PersonEntity:
          Name:
            NameFull: Bellemore, Frances A.
      – PersonEntity:
          Name:
            NameFull: Epstein, Ronald M.
      – PersonEntity:
          Name:
            NameFull: Butow, Phyllis N.
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 03
              Text: Mar2015
              Type: published
              Y: 2015
          Identifiers:
            – Type: issn-print
              Value: 10579249
          Numbering:
            – Type: volume
              Value: 24
            – Type: issue
              Value: 3
          Titles:
            – TitleFull: Psycho-Oncology
              Type: main
ResultId 1