Jump to content

  • Set Your Location
  • Sign in or Enroll
Set Your LocationSutter Pacific 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
    • Video Visits
    • Find Doctors
    • Find Locations
    • Treatments & Services
    • COVID-19 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
  • Sutter Pacific
  • 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

Experiences of primary care physicians and staff following Lean workflow redesign.

Hung DY, Harrison MI, Truong Q, Du X.
BMC Health Serv Res. 18(1):274. doi: 10.1186/s12913-018-3062-5.
2018 Apr 10

Patients' medication-related experience of care is associated with adherence to cardiometabolic disease therapy in real-world clinical practice.

Romanelli RJ, Huang Q, LaMori J, Doshi D, Chung S.
Popul Health Manag. doi: 10.1089/pop.2017.0163. [Epub ahead of print]
2018 Mar 12

Beyond consent: building trusting relationships with diverse populations in precision medicine research.

Kraft SA, Cho MK, Gillespie K, Halley M, Varsava N, Ormond KE, Luft HS, Wilfond BS, Soo-Jin Lee S.
Am J Bioeth. 18(4):3-20. doi: 10.1080/15265161.2018.1431322.
2018 Apr 01

HOMBRE: A randomized controlled trial to compare two approaches to weight loss for overweight and obese Latino men (men with choices to improve well-being and decrease chronic disease risk).

Rosas LG, Lv N, Azar KMJ, Xiao L, Hooker SP, Lewis MA, Zavella P, Venditti EM, Ma J.
Contemp Clin Trials. pii: S1551-7144(17)30629-8. doi: 10.1016/j.cct.2018.02.019. [Epub ahead of print]
2018 Mar 02

Personalized hypertension management using patient-generated health data integrated with electronic health records (EMPOWER-H): six-month pre-post study.

Lv N, Xiao L, Simmons ML, Rosas LG, Chan A, Entwistle M.
J Med Internet Res. 19(9):e311. doi: 10.2196/jmir.7831.
2017 Sep 19
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.

  • Contact Us
  • Find Doctors
  • Find Locations
  • Request Medical Records
  • Make a Gift
Sign in to My Health Online

Billing and Insurance

  • Pay a Bill
  • Accepted Health Plans
  • Estimate Costs
  • Medicare Advantage

About Sutter

  • About Our Network
  • Community Benefit
  • Annual Report
  • News

Our Team

  • For Employees
  • For Medical Professionals
  • For Vendors
  • For Volunteers

Careers

  • Jobs at Sutter
  • Physician Jobs
  • Graduate Medical Education

Copyright © 2023 Sutter Health. All rights reserved. Sutter Health is a registered trademark of Sutter Health ®, Reg. U.S. Patent & Trademark office.

  • ADA Accessibility
  • Privacy
  • Do Not Sell My Personal Information
  • LinkedIn Opens new window
  • YouTube Opens new window
  • Facebook Opens new window
  • Twitter Opens new window
  • Instagram Opens new window
  • Glassdoor Opens new window

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