Do patients with lung cancer recall physician-initiated discussions about planning for end-of-life care following disclosure of a terminal prognosis?
Advance Care Planning
/ statistics & numerical data
Aged
Aged, 80 and over
Communication
Disclosure
England
Family
/ psychology
Female
Humans
Lung Neoplasms
/ psychology
Male
Middle Aged
Physician-Patient Relations
Physicians
/ psychology
Qualitative Research
Terminal Care
/ psychology
Terminally Ill
/ psychology
Advance care planning
Communication
Prognosis
Terminal care
Journal
BMJ supportive & palliative care
ISSN: 2045-4368
Titre abrégé: BMJ Support Palliat Care
Pays: England
ID NLM: 101565123
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
received:
16
09
2015
revised:
04
12
2015
accepted:
10
01
2016
pubmed:
5
2
2016
medline:
30
7
2019
entrez:
5
2
2016
Statut:
ppublish
Résumé
Communicating with patients about their prognosis and goals of care, including offering opportunities to engage in advance care planning (ACP) is widely recognised as best practice. Little is known about terminally ill patients' perceptions of communication and ACP practice following disclosure of their terminal prognosis. To examine whether terminally ill patients with lung cancer and their relatives recall conversations with disclosing physicians, about their concerns, goals of care or any offers to engage in ACP. Qualitative study using semistructured interviews with patients and their family members. The study setting was a cancer centre and cancer unit in northern England. 25 patients with advanced lung cancer (18 men and 7 women, aged 47-85) and 19 family members, mainly from lower social economic classes, took part in the study. Participants had little or no recall of physicians initiating discussions about their concerns, or goals of care and did not perceive that they had been provided with either information about or opportunities to engage in ACP. Some participants reported a sense of abandonment following the disclosure of a terminal prognosis. This sense was compounded by a range of difficult emotional experiences following the disclosure. It may be inappropriate to initiate discussions about end-of-life care planning immediately following the disclosure of a terminal prognosis. To avoid patients feeling abandoned physicians need to consider how they or another appropriate person can provide information and opportunities for terminally ill patients to engage in a process of ACP. 06/Q2307/22.
Sections du résumé
BACKGROUND
BACKGROUND
Communicating with patients about their prognosis and goals of care, including offering opportunities to engage in advance care planning (ACP) is widely recognised as best practice. Little is known about terminally ill patients' perceptions of communication and ACP practice following disclosure of their terminal prognosis.
OBJECTIVES
OBJECTIVE
To examine whether terminally ill patients with lung cancer and their relatives recall conversations with disclosing physicians, about their concerns, goals of care or any offers to engage in ACP.
METHODS
METHODS
Qualitative study using semistructured interviews with patients and their family members. The study setting was a cancer centre and cancer unit in northern England.
RESULTS
RESULTS
25 patients with advanced lung cancer (18 men and 7 women, aged 47-85) and 19 family members, mainly from lower social economic classes, took part in the study. Participants had little or no recall of physicians initiating discussions about their concerns, or goals of care and did not perceive that they had been provided with either information about or opportunities to engage in ACP. Some participants reported a sense of abandonment following the disclosure of a terminal prognosis. This sense was compounded by a range of difficult emotional experiences following the disclosure.
CONCLUSIONS
CONCLUSIONS
It may be inappropriate to initiate discussions about end-of-life care planning immediately following the disclosure of a terminal prognosis. To avoid patients feeling abandoned physicians need to consider how they or another appropriate person can provide information and opportunities for terminally ill patients to engage in a process of ACP.
TRIAL REGISTRATION NUMBER
BACKGROUND
06/Q2307/22.
Identifiants
pubmed: 26842461
pii: bmjspcare-2015-001015
doi: 10.1136/bmjspcare-2015-001015
doi:
Types de publication
Journal Article
Langues
eng
Pagination
197-201Informations de copyright
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.