Effects of an Oncology Nurse-Led, Primary Palliative Care Intervention (CONNECT) on Illness Expectations Among Patients With Advanced Cancer

Sigler, Lauren; Althouse, Andrew D.; Thomas, Teresa Hagan; Arnold, Robert M.; White, Douglas B.; Smith, Thomas J.; Chu, Edward; Rosenzweig, Margaret; Schenker, Yael

doi:10.1200/op.21.00573

Cited by 3 publications

(1 citation statement)

References 62 publications

(141 reference statements)

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“…Ongoing research is needed to develop personalized, simple, and effective methods of conveying prognosis and facilitating understanding, when and as desired by patients and caregivers. 31 , 32 , 33 , 34 Future communication interventions may require specific roles for nursing professionals, 17 , 35 , 36 oncologists, and palliative care specialists, with a framework that can be acted upon early and that can adapt to all stages and types of cancers.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of curability expectations in patients with gastrointestinal cancers

et al. 2022

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Background Assessment of illness and treatment understanding among cancer patients has largely focused on those with advanced disease. Less is known about patient expectations at earlier stages of cancer and potential modifiers of accurate understanding. Methods We assessed accuracy of cure expectations in patients across all stages with gastrointestinal (GI) cancers. Accuracy was determined by independent reviews of patient health records by oncologists on the investigative team. Impact on cure accuracy of selected clinical variables and health‐information preferences was analyzed. Results Hundred and thirty five patients were included for analysis, with 100% interrater agreement for accuracy between oncologist reviewers. Sixety five patients (48%) had accurate cure expectations from their cancer treatment. Accuracy was lower in Stage IV versus Stage I–III disease (35% vs. 63%, p < 0.01), lower in unresectable versus resectable disease (35% vs. 67%, p < 0.01), and higher in patients with early‐stage disease who received adjuvant chemotherapy versus those who did not (78% vs. 53%, p = 0.04). Accuracy did not differ by health‐information preferences and remained stable over time. Of 63 patients who died, baseline accuracy differed by location of death ( p = 0.03), with greater accuracy in those who died with home hospice (56%). Accuracy was lower in those who were hospitalized in the last 30 days of life versus those who were not (25% vs. 59%, p = 0.01). Conclusions Inaccurate cure expectations are prevalent across all stages of GI cancers, but particularly among those with metastatic or unresectable disease. High‐quality, iterative communication strategies may facilitate patient illness and treatment understanding throughout the disease course.

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