Conducting Goals-of-Care Discussions Takes Less Time Than Imagined
| Autor: | Kerin B. Adelson, Nina A. Bickell, Rebeca Franco, Sofya Pintova, Natalia Egorova, Cardinale B. Smith, Ryan Leibrandt, Jason Gonsky |
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| Rok vydání: | 2020 |
| Předmět: | |
| Zdroj: | JCO Oncology Practice. 16:e1499-e1506 |
| ISSN: | 2688-1535 2688-1527 |
| DOI: | 10.1200/jop.19.00743 |
| Popis: | PURPOSE: To describe the length of encounter during visits where goals-of-care (GoC) discussions were expected to take place. METHODS: Oncologists from community, academic, municipal, and rural hospitals were randomly assigned to receive a coaching model of communication skills to facilitate GoC discussions with patients with newly diagnosed advanced solid-tumor cancer with a prognosis of < 2 years. Patients were surveyed after the first restaging visit regarding the quality of the GoC discussion on a scale of 0-10 (0 = worst; 10 = best), with ≥ 8 indicating a high-quality GoC discussion. Visits were audiotaped, and total encounter time was measured. RESULTS: The median face-to-face time oncologists spent during a GoC discussion was 15 minutes (range, 10-20 minutes). Among the different hospital types, there was no significant difference in encounter time. There was no difference in the length of the encounter whether a high-quality GoC discussion took place or not (15 v 14 minutes; P = .9). If there was imaging evidence of cancer progression, the median encounter time was 18 minutes compared with 13 minutes for no progression ( P = .03). In a multivariate model, oncologist productivity, patient age, and Medicare coverage affected duration of the encounter. CONCLUSION: Oncologists can complete high-quality GoC discussions in 15 minutes. These data refute the common misperception that discussing such matters with patients with advanced cancer requires significant time. |
| Databáze: | OpenAIRE |
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