Background Patients, families and health care providers can be apprehensive about having end-of-life (EOL) conversations in Oncology. However, asking patients about personal values regarding their healthcare goals creates a platform for more in depth conversations.
Aim To test a structured process for identifying eligible patients for upstream advance care planning (ACP) conversations through development and validation of a quantitative instrument.
Methods Recruitment was conducted at seven cancer centres in the USOncology Network over a 90-day pilot study. A cross-sectional descriptive design was used in 301 metastatic cancer patients. Sixty-three participants completed the questionnaire. The 13-item instrument was created after a literature review regarding EOL choices and interventions using a 5-point Likert scale. Descriptive statistics were examined, in addition to analysis of the relationships between items using Pearson's r correlations.
Results 59% of participants were female, predominantly Caucasian, with a mean age of 66 years. 68% reported the importance of being told by their oncologist when dying. Additionally, 76% reported the importance of selecting who would make medical decisions for them. Lastly, 62% reported the importance of choosing where their EOL medical care occurs. There was a significant association between discussing feelings about dying and being told by a physician when dying, (r=0.373, p<0.01).
Discussion and Conclusion The instrument allows for healthcare providers to understand the patient's needs, creating a segue for patient collaboration during EOL care. ACP conversations can be further developed through review of the validated instrument in adults with life-limiting illness in Oncology.
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