Samenvatting
Background
Discussing incurable cancer, treatment options and prognosis is for most oncologists a very difficult issue in clinical practice and is often avoided, leading to delays in transition to adequate palliative care. As first phase in the development of a clinical guidance tool for such discussions, an interview study was designed with oncologists, advanced cancer patients and family members to identify key factors in conducting discussions of incurability and palliative care.
Method
Several methodological requirements guided the drafting of the protocol. A qualitative approach was the most appropriate to gain insight in preferences, opinions and experiences. Special attention was paid to the recruitment of oncologists, and of patients and family members given their vulnerability and the sensitivity of the topic. Another challenge was to motivate and persuade oncologists to participate.
Results
Semi-structured in-depth interviews were used to gather data. A purposive sample of 10 to 15 participants was selected for each interview group: oncologists, patients and family members. Recruitment of all participants was done from 33 Belgian Medical Oncology Departments. Oncologists received monetary compensation for interviews which were scheduled according to their timetable and lasted at most 1 hour. They were also asked to identify and approach advanced cancer patients under their care with whom they had communicated incurability and palliative care options. Patients who agreed to participate identified the most relevant family member. Interviews were conducted in an environment where patients felt comfortable, mostly in their own home, and overly burdening and confronting questions were avoided.
Discussion
Ample measures were taken to counter oncologists' lack of time to participate in studies, and to minimise emotional burden for patients. This study will provide a strong basis for creating a clinical guidance tool and communication training for physicians.
Discussing incurable cancer, treatment options and prognosis is for most oncologists a very difficult issue in clinical practice and is often avoided, leading to delays in transition to adequate palliative care. As first phase in the development of a clinical guidance tool for such discussions, an interview study was designed with oncologists, advanced cancer patients and family members to identify key factors in conducting discussions of incurability and palliative care.
Method
Several methodological requirements guided the drafting of the protocol. A qualitative approach was the most appropriate to gain insight in preferences, opinions and experiences. Special attention was paid to the recruitment of oncologists, and of patients and family members given their vulnerability and the sensitivity of the topic. Another challenge was to motivate and persuade oncologists to participate.
Results
Semi-structured in-depth interviews were used to gather data. A purposive sample of 10 to 15 participants was selected for each interview group: oncologists, patients and family members. Recruitment of all participants was done from 33 Belgian Medical Oncology Departments. Oncologists received monetary compensation for interviews which were scheduled according to their timetable and lasted at most 1 hour. They were also asked to identify and approach advanced cancer patients under their care with whom they had communicated incurability and palliative care options. Patients who agreed to participate identified the most relevant family member. Interviews were conducted in an environment where patients felt comfortable, mostly in their own home, and overly burdening and confronting questions were avoided.
Discussion
Ample measures were taken to counter oncologists' lack of time to participate in studies, and to minimise emotional burden for patients. This study will provide a strong basis for creating a clinical guidance tool and communication training for physicians.
| Originele taal-2 | English |
|---|---|
| Pagina's (van-tot) | 837-837 |
| Aantal pagina's | 1 |
| Tijdschrift | Palliative Medicine |
| Volume | 28 |
| Status | Published - 2014 |
| Evenement | 8th world research congress of the European Association for Palliative Care (EAPC) - Lleida, Spain Duur: 5 jun 2014 → 7 jun 2014 |