Death and the treatment imperative: Decision-making in late-stage cancer

Tate, Alexandra

doi:10.1016/j.socscimed.2022.115129

Cited by 8 publications

(10 citation statements)

References 43 publications

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“…This study further elucidates specific behaviours conducive to the implementation of humanistic palliative care, including fostering a caring atmosphere and establishing beneficial doctor–patient interactions. These specific behaviours have already been implemented in oncology wards, enhancing patients’ perceptions of humanistic care, as corroborated by the findings of other research 29 30…”

Section: Discussionsupporting

confidence: 65%

Experience of multidisciplinary medical teams on humanistic palliative care in oncology wards: a descriptive qualitative study in Southern China

Liang,

et al. 2024

BMJ Open

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ObjectivesThis study aimed to explore the experiences of multidisciplinary medical teams in implementing humanistic palliative care within the oncology ward.DesignPurposive and snowball sampling methods were used in this qualitative study, which involved conducting semistructured interviews to gather personal experiences from members of multidisciplinary medical teams providing humanistic palliative care in the oncology ward.SettingThe research was conducted in the oncology ward of a tertiary hospital located in Foshan, China.ParticipantsParticipants included 4 doctors, 12 nurses and 2 medical social workers who form the multidisciplinary medical team responsible for delivering humanistic palliative care to patients with cancer in oncology wards.ResultsPhenomenological qualitative analysis yielded 3 main themes and 9 subthemes. The identified themes were as follows: (1) conceptual change, (2) concrete actions and (3) facilitators and barriers to the implementation of humanistic palliative care.ConclusionThe findings suggest a need for strengthening humanistic consciousness among multidisciplinary palliative care teams working in oncology wards, although there has been a gradual improvement in humanistic care behaviours. Furthermore, facilitators and barriers coexist in the implementation of humanistic palliative care. Efforts should be directed towards refining mechanisms that promote humanistic palliative care, fostering the enthusiasm of healthcare professionals, conducting systematic training to enhance their humanistic care abilities and striving for improvements in the quality of medical services for the benefit of both patients and their families.

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Section: Discussionsupporting

confidence: 65%

Experience of multidisciplinary medical teams on humanistic palliative care in oncology wards: a descriptive qualitative study in Southern China

Liang,

et al. 2024

BMJ Open

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“…(Dr.2) This last excerpt is an example of the existing confusion over ADs and ACP in Mexico 20 . While ADs focus primarily on EOL issues, ACP aims to discuss and align medical interventions with patients' preferences and values during the whole cancer trajectory 5,16,19 . Thus, during the interviews, I paraphrased the question specifically using the phrase "advance care planning."…”

Section: Planningmentioning

confidence: 99%

“…Research shows that ACP poses specific challenges for oncologists, such as uncertainty over when to start ACP conversations 16 , their fear of damaging their relationship with patients, their drive to save lives, and the complexity present in prognostication 17,18 . Other challenges include the insidious biomedical model of care, applied even when treatments become futile 19 , misunderstandings of what ACP is 20,21 , and the subjectivity present in assessing the patient's capacity for agency 9 . Altogether, these prevent ACP conversations from taking place 22 .…”

Section: Introductionmentioning

confidence: 99%

Oncologists´ perspectives on patients´autonomy within advance care planning in Mexico City

Tarditi

2024

GAMO

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Background: Patients' autonomy (PA) and advance care planning (ACP) are cardinal features within the doctor-patient relationship. Nonetheless, little is known in Mexico about oncologists' perspectives on these issues. Objectives: To explore the roles and responsibilities medical oncologists working in Mexico City perceive themselves as having when discussing and implementing ACP, supporting PA, and the challenges they encounter on these issues in their practice. Methods: Qualitative, semi-structured, in-depth interviews with 10 oncologists working in Mexico City. A thematic analysis approach was used for interpreting interviews. Results: Paternalism has an influence in and beyond the medical field in Mexico, and so it may be better understood as a cultural script. Further, ACP is mainly understood as end-of-life care planning, and the concept of relational autonomy is almost unknown. Health system fragmentation and a lack of communication skills are identified as additional obstacles. Conclusion: To narrow the gap between theory and practice, it is important to develop a consensus over ACP's definition, aims, and scope. Finally, it is important to understand better how Mexican paternalism, as a cultural script, reinforces the paternalistic model of care, which limits PA.

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“…Past studies have analyzed video-recorded healthcare encounters to examine how treatment decisions are made in situ (Wang 2020;Stivers & Timmermans 2021;Tate 2022;McCabe 2021;Ostermann 2021;Dalby Landmark et al 2017;Kaminskiy & Finlay 2019;Pino et al 2020). These studies use Conversation Analysis (Sidnell & Stivers 2012;Tietbohl & White 2022) to microanalyze video-recorded clinical interactions and identify systematic patterns in how practitioners mental versus physical health diagnosis (Tate 2019).…”

Section: Literaturementioning

confidence: 99%

Gatekeeping and factors underlying decisions not to refer to mental health services after self-harm: Triangulating video-recordings of consultations, interviews, medical records and discharge letters

Bergen

Lomas

Ryan

2023

SSM - Qualitative Research in Health

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Death and the treatment imperative: Decision-making in late-stage cancer

Cited by 8 publications

References 43 publications

Experience of multidisciplinary medical teams on humanistic palliative care in oncology wards: a descriptive qualitative study in Southern China

Experience of multidisciplinary medical teams on humanistic palliative care in oncology wards: a descriptive qualitative study in Southern China

Oncologists´ perspectives on patients´autonomy within advance care planning in Mexico City

Gatekeeping and factors underlying decisions not to refer to mental health services after self-harm: Triangulating video-recordings of consultations, interviews, medical records and discharge letters

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