Breaking silence: a survey of barriers to goals of care discussions from the perspective of oncology practitioners
| Autor: | Sukhbinder Dhesy-Thind, Yudong Liu, Leslie Martin, Matthew Patel, Arthur Wong, Alexandra Patel, Ameen Patel, John J. You, Katrina Lynn Piggott |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male 0301 basic medicine Oncology Cancer Research medicine.medical_specialty Attitude of Health Personnel Decision Making Language barrier Medical Oncology Goals of care discussions lcsh:RC254-282 Patient Care Planning Likert scale 03 medical and health sciences 0302 clinical medicine Surveys and Questionnaires Internal medicine Health care Genetics medicine Humans Cancer care Cause of death Oncologists Response rate (survey) business.industry Communication Perspective (graphical) Middle Aged lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Silence Cross-Sectional Studies 030104 developmental biology Health Care Surveys 030220 oncology & carcinogenesis End of life Female business Developed country Barriers Research Article |
| Zdroj: | BMC Cancer, Vol 19, Iss 1, Pp 1-8 (2019) BMC Cancer |
| ISSN: | 1471-2407 |
| Popis: | Background Cancer is the leading cause of death in the developed world, and yet healthcare practitioners infrequently discuss goals of care (GoC) with hospitalized cancer patients. We sought to identify barriers to GoC discussions from the perspectives of staff oncologists, oncology residents, and oncology nurses. Methods This was a single center survey of staff oncologists, oncology residents, and inpatient oncology nurses. Barriers to GoC discussions were assessed on a 7-point Likert scale (1 = extremely unimportant; 7 = extremely important). Results Between July 2013 and May 2014, of 185 eligible oncology clinicians, 30 staff oncologists, 10 oncology residents, and 28 oncology nurses returned surveys (response rate of 37%). The most important barriers to GoC discussions were patient and family factors. They included family members’ difficulty accepting poor prognoses (mean score 5.9, 95% CI [5.7, 6.2]), lack of family agreement in the goals of care (mean score 5.8, 95% CI [5.5, 6.1]), difficulty understanding the limitations of life-sustaining treatments (mean score 5.8, 95% CI [5.6, 6.1]), lack of patients’ capacity to make goals of care decisions (mean score 5.7, 95% CI [5.5, 6.0]), and language barriers (mean score 5.7, 95% CI [5.4, 5.9]). Participants viewed system factors and healthcare provider factors as less important barriers. Conclusions Oncology practitioners perceive patient and family factors as the most limiting barriers to GoC discussions. Our findings underscore the need for oncology clinicians to be equipped with strong communication skills to help patients and families navigate GoC discussions. Electronic supplementary material The online version of this article (10.1186/s12885-019-5333-x) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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