Framework for timing of the discussion about forgoing cancer-specific treatment based on a qualitative study with oncologists.
Background: Many patients with advanced cancer receive aggressive chemotherapy close to death and are referred too late to palliative or hospice care.Aim: The aim of this study was to investigate oncologists' and oncology nurses' perceptions of the optimal timing for discussions about forgoing cance...
| Publicado en: | Supportive Care in Cancer Vol. 23; no. 3; pp. 715 - 722 |
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| Autores principales: | , , , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
Mar2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=109775692&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 109775692 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09414355 O1J jtl: Supportive Care in Cancer issn: 09414355 maglogo: N pubinfo: dt: Mar2015 vid: 23 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 109775692 NLM25172311 2012888939 10.1007/s00520-014-2416-8 NLM25172311 109775692 ppf: 715 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Framework for timing of the discussion about forgoing cancer-specific treatment based on a qualitative study with oncologists. aug: au: Laryionava, K Heußner, P Hiddemann, W Winkler, E C affil: Department of Medical Oncology, National Center for Tumor Diseases (NCT), Programme for Ethics and Patient-oriented Care, Heidelberg University Hospital , Im Neuenheimer Feld 460, 69120, Heidelberg, Germany, katsiaryna.laryionava@med.uni-heidelberg.de. sug: subj: Advance Care Planning Decision Making Neoplasms Therapy Attitude of Health Personnel Female Human Interviews Male Nurses Perception Physicians Qualitative Studies Time Factors Female Male ab: Background: Many patients with advanced cancer receive aggressive chemotherapy close to death and are referred too late to palliative or hospice care.Aim: The aim of this study was to investigate oncologists' and oncology nurses' perceptions of the optimal timing for discussions about forgoing cancer-specific therapy at the End-of-Life (EOL) and the reasons that might hinder them.Design: Qualitative in-depth interviews with oncologists and oncology nurses were carried out. The empirical data were evaluated from a normative perspective.Setting/participants: Twenty-nine physicians and nurses working at the Department of Hematology and Oncology of a German university hospital were interviewed.Results: Health-care professionals differed considerably in their understanding of when to initiate discussions about forgoing cancer-specific therapy at the EOL. However, their views could be consolidated into three approaches: (1) preparing patients gradually throughout the course of disease (anticipatory approach) which is best suited to empower patient self-determination in decision-making, (2) waiting until the patient him/herself starts the discussion about forgoing cancer-specific treatment, and (3) waiting until all tumor-specific therapeutic options are exhausted.Conclusion: The empirically informed ethical analysis clearly favors an approach that prepares patients for forgoing cancer-specific therapy throughout the course of disease. Since the last two approaches often preclude advance care planning, these approaches may be less ethically acceptable. The proposed framework could serve as a starting point for the development of concrete recommendations on the optimal timing for EOL discussions. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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