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Advance Care Planning and Goals of Care Discussion: Barriers from the Perspective of Medical Residents

Background: Advance care planning (ACP) and goals of care discussion involve the exploration of what is most important to a person to prepare for health-care decision making. Despite their well-established benefits, they are still not frequently performed in clinical oncology practice. This study ai...

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Autores principales: Dias, Laiane Moraes, Frutig, Mayra de Almeida, Bezerra, Mirella Rebello, Barra, Williams Fernandes, Castro, Luísa, Rego, Francisca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9961136/
https://www.ncbi.nlm.nih.gov/pubmed/36833934
http://dx.doi.org/10.3390/ijerph20043239
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author Dias, Laiane Moraes
Frutig, Mayra de Almeida
Bezerra, Mirella Rebello
Barra, Williams Fernandes
Castro, Luísa
Rego, Francisca
author_facet Dias, Laiane Moraes
Frutig, Mayra de Almeida
Bezerra, Mirella Rebello
Barra, Williams Fernandes
Castro, Luísa
Rego, Francisca
author_sort Dias, Laiane Moraes
collection PubMed
description Background: Advance care planning (ACP) and goals of care discussion involve the exploration of what is most important to a person to prepare for health-care decision making. Despite their well-established benefits, they are still not frequently performed in clinical oncology practice. This study aims to describe the barriers to discussion goals of care with oncology patients from the perspective of medical residents. Methods. This cross-sectional and qualitative study applied the “Decide-Oncology” questionnaire, adapted to Portuguese language, to assess barriers to goals of care discussion among medical residents from three university hospitals in Brazil. Residents were asked to rank the importance of various barriers to discuss goals of care (ranging from 1—extremely unimportant to 7—extremely important). Results: Twenty-nine residents answered the questionnaire (30.9%). The most reported barriers were related to patients and their families’ difficulty in understanding and accepting the diagnosis and the prognosis as well as patients’ desire to receive full active treatment. Furthermore, the physician and external factors such as lack of training and lack of time to have these conversations were also very important barriers. The identification of the key barriers that limit the discussion of ACP and early palliative care referrals can certainly help to prioritize the next steps for future studies aimed at improving ACP and goals of care discussions.
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spelling pubmed-99611362023-02-26 Advance Care Planning and Goals of Care Discussion: Barriers from the Perspective of Medical Residents Dias, Laiane Moraes Frutig, Mayra de Almeida Bezerra, Mirella Rebello Barra, Williams Fernandes Castro, Luísa Rego, Francisca Int J Environ Res Public Health Article Background: Advance care planning (ACP) and goals of care discussion involve the exploration of what is most important to a person to prepare for health-care decision making. Despite their well-established benefits, they are still not frequently performed in clinical oncology practice. This study aims to describe the barriers to discussion goals of care with oncology patients from the perspective of medical residents. Methods. This cross-sectional and qualitative study applied the “Decide-Oncology” questionnaire, adapted to Portuguese language, to assess barriers to goals of care discussion among medical residents from three university hospitals in Brazil. Residents were asked to rank the importance of various barriers to discuss goals of care (ranging from 1—extremely unimportant to 7—extremely important). Results: Twenty-nine residents answered the questionnaire (30.9%). The most reported barriers were related to patients and their families’ difficulty in understanding and accepting the diagnosis and the prognosis as well as patients’ desire to receive full active treatment. Furthermore, the physician and external factors such as lack of training and lack of time to have these conversations were also very important barriers. The identification of the key barriers that limit the discussion of ACP and early palliative care referrals can certainly help to prioritize the next steps for future studies aimed at improving ACP and goals of care discussions. MDPI 2023-02-13 /pmc/articles/PMC9961136/ /pubmed/36833934 http://dx.doi.org/10.3390/ijerph20043239 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Dias, Laiane Moraes
Frutig, Mayra de Almeida
Bezerra, Mirella Rebello
Barra, Williams Fernandes
Castro, Luísa
Rego, Francisca
Advance Care Planning and Goals of Care Discussion: Barriers from the Perspective of Medical Residents
title Advance Care Planning and Goals of Care Discussion: Barriers from the Perspective of Medical Residents
title_full Advance Care Planning and Goals of Care Discussion: Barriers from the Perspective of Medical Residents
title_fullStr Advance Care Planning and Goals of Care Discussion: Barriers from the Perspective of Medical Residents
title_full_unstemmed Advance Care Planning and Goals of Care Discussion: Barriers from the Perspective of Medical Residents
title_short Advance Care Planning and Goals of Care Discussion: Barriers from the Perspective of Medical Residents
title_sort advance care planning and goals of care discussion: barriers from the perspective of medical residents
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9961136/
https://www.ncbi.nlm.nih.gov/pubmed/36833934
http://dx.doi.org/10.3390/ijerph20043239
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