Jump to content

Choose locationPalo Alto Medical Foundation
  • Sign in or Enroll
    • Open I want to choose my medical group or hospital
    • Clear my location
Change Location
Sutter Health
  • Video Visits
  • Find Doctors
  • Find Locations
  • Treatments & Services
  • Locations
  • Sign in or Enroll
    • Video Visits
    • Find Doctors
    • Find Locations
    • Treatments & Services
    • COVID-19 Resources
    • Monkeypox Resources
    • Pay a Bill
    • Symptom Checker
    • Get Care Today
    • Health & Wellness
    • Classes & Events
    • Research & Clinical Trials
    • For Patients
    • About Sutter Health
    • Giving
    • Volunteering
    • Careers
    • News
    • For Medical Professionals
    • Other Business Services
Close Search
  • Home
  • PAMF
  • Research
  • Health Services
Content

Evolving goals of care discussions as described in interviews with individuals with advanced cancer and oncology and palliative care teams.

Description

Dillon EC, Meehan A, Nasrallah C, Lai S, Colocci N, Luft H., Am J Hosp Palliat Care. 1049909120969202. doi: 10.1177/1049909120969202. Online ahead of print., 2020 Oct 28

Investigators

Natalia Colocci, M.D., Ph.D.

Abstract

Background: Individuals with advanced cancer and their families have negative end-of-life experiences when the care they receive is not aligned with their values and preferences.

Objective: To obtain in-depth information on how patients with advanced cancer and the oncology and palliative care (PC) clinicians who care for them discuss goals of care (GoC).

Design: The research team conducted in-depth interviews and qualitative data analysis using open coding to identify how perspectives on GoC discussions vary by stage of illness, and experience with PC teams.

Setting/subjects: Twenty-five patients and 25 oncology and PC team members in a large multi-specialty group in Northern California.

Results: At the time of diagnosis participants described having establishing GoC conversations about understanding the goal of treatment (e.g. to extend life), and prognosis ("How much time do I have?"). Patients whose disease progressed or pain/symptoms increased reported changing GoC conversations about stopping treatment, introducing hospice care, prognostic awareness, quality of life, advance care planning, and end-of-life planning. Participants believed in the fluidity of prognosis and preferences for prognostic communication varied. Patients appreciated how PC teams facilitated changing GoC conversations. Timing was challenging; some patients desired earlier conversations and PC involvement, others wanted to wait until things were "going downhill."

Conclusion: Patients and clinical teams acknowledged the complexity and importance of GoC conversations, and that PC teams enhanced conversations. The frequency, quality, and content of GoC conversations were shaped by patient receptivity, stage of illness, clinician attitudes and predispositions toward PC, and early integration of PC.

Pubmed Abstract

Pubmed AbstractOpens New Window

Associated Topics

  • Cancer
  • Disease Management
  • Health Services

Related Publications

Features of patient-centered primary care and the use of ambulatory care.

Wong P, Panattoni L, Tai-Seale M.
Popul Health Manag. doi: 10.1089/pop.2016.0079. [Epub ahead of print]Send to
2017 Jan 11

World Endometriosis Society consensus on the classification of endometriosis.

Johnson NP, Hummelshoj L, Adamson GD, Keckstein J, Taylor HS, Abrao MS, Bush D, Kiesel L, Tamimi R, Sharpe-Timms KL, Rombauts L, Giudice LC; for the World Endometriosis Society Sao Paulo Consortium.
Hum Reprod. [Epub ahead of print]
2016 Dec 05

A clinician's guide to privacy and communication in the ICU.

Francis L, Vorwaller MA, Aboumatar H, Frosch DL, Halamka J, Rozenblum R, Rubin E, Lee BS, Sugarman J, Turner K, Brown SM; Privacy, Access, and Engagement Task Force of the Libretto Consortium of the Gordon and Betty Moore Foundation.
Crit Care Med. [Epub ahead of print]
2016 Dec 02

Use of a motivational interviewing-informed strategy in group orientations to improve retention and intervention attendance in a randomized controlled trial..

Xiao L, Lv N, Rosas LG, Karve S, Luna V, Jameiro E, Wittels N, Ma J.
Health Educ Res. 31(6):729-737. Epub 2016 Oct 10.
2016 Dec 01

Ready for change? The role of physician and staff engagement, burnout, and workplace attributes.

Hung D, Chen PH.
J Ambul Care Manage. [Epub ahead of print]
2016 Nov 23
The Sutter Health Network of Care
Expertise to fit your needs
Primary Care

Check-ups, screenings and sick visits for adults and children.

Specialty Care

Expertise and advanced technologies in all areas of medicine.

Emergency Care

For serious accidents, injuries and conditions that require immediate medical care.

Urgent Care

After-hours, weekend and holiday services.

Walk-In Care

Convenient walk-in care clinics for your non-urgent health needs.

About Sutter

  • About Our Network
  • Annual Report
  • Awards
  • Community Benefit
  • Contact Us
  • News
  • Giving
  • Find Care

  • Birth Centers
  • Care Centers
  • Emergency Rooms
  • Hospitals
  • Imaging
  • Labs
  • Surgery Centers
  • Urgent Care
  • Walk-In Care
  • View All >
  • Featured Services

  • Behavioral Health
  • Cancer Services
  • Family Medicine
  • Home Health and Hospice
  • Orthopedics
  • Pediatrics
  • Pregnancy
  • Primary Care
  • Women's Health
  • View All >
  • Patient Resources

  • Accepted Health Plans
  • Classes and Events
  • Estimate Costs
  • Health and Wellness
  • Medical Records
  • Medicare Advantage
  • My Health Online
  • Pay a Bill
  • Symptom Checker
  • Our Team

  • For Employees
  • Physician Careers
  • Recruiting Events
  • Residencies and Fellowships
  • Sutter Careers
  • Vendors
  • Volunteers
    • ADA Accessibility
    • Contact
    • Privacy
    • Do Not Sell My Personal Information

    • LinkedIn Opens new window
    • YouTube Opens new window
    • Facebook Opens new window
    • Twitter Opens new window
    • Glassdoor Opens new window
    • Instagram Opens new window

    Copyright © 2022 Sutter Health. All rights reserved. Sutter Health is a registered trademark of Sutter Health ®, Reg. U.S. Patent & Trademark office.

    Cookie Policy

    We use cookies to give you the best possible user experience. By continuing to use the site, you agree to the use of cookies. Privacy Policy Cookie Preferences

    Privacy Policy Cookie Preferences