Promoting End-of-Life Discussions in Advanced Cancer: Effects of Patient Coaching and Question Prompt Lists

Rodenbach, Rachel; Brandes, Kim; Fiscella, Kevin; Kravitz, Richard L.; Butow, Phyllis; Walczak, Adam; Duberstein, Paul R.; Sullivan, Peter B.; Hoh, Beth; Xing, Guibo; Plumb, Sandy; Epstein, Ronald M.

doi:10.1200/jco.2016.68.5651

Cited by 79 publications

(74 citation statements)

References 34 publications

(3 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Coaches and trust persons are important for supporting patients in preparation for their consultation, accompanying patients to the consultation and discussing their emotions. Previous studies evaluated the effectiveness of a coach on patient participation in oncology consultations (e.g., Rodenbach et al, ; Street et al, ). These studies showed that a preparation session with a coach prior to a consultation increased the discussion of emotional topics such as prognosis (Rodenbach et al, ) and affected question‐asking behaviour, assertiveness and the expression of pain‐related concerns (Street et al, ).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…These studies showed that a preparation session with a coach prior to a consultation increased the discussion of emotional topics such as prognosis (Rodenbach et al, 2017) and affected question-asking behaviour, assertiveness and the expression of pain-related concerns (Street et al, 2010). However, patients are not always aware that these initiatives exist.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Cancer patients' needs for support in expressing instrumental concerns and emotions

et al. 2019

Self Cite

View full text Add to dashboard Cite

Introduction The aim of our study was to provide an overview of intervention guidelines on how to address patients' practical needs for support in expressing instrumental concerns and emotions regarding medical, psychosocial and practical topics. Methods Six focus groups of cancer patients and survivors (N = 39) were organised. An interview guide was created that consisted of three topics: (a) concerns, (b) needs for support, and (c) a Concern Prompt List. Using the framework method, the transcripts were coded and analysed in Atlas T.I. Results Patients prefer to receive practical and emotional support, help with preparation, prompts/cues, instructions on how to perform the behaviour (i.e., express their concerns or emotions), feedback, a different structure for the consultation and tailoring. Most of these techniques should preferably be delivered via interpersonal communication. Needs sometimes differ for instrumental concerns and emotions. Only some needs for support were exclusively related to instrumental concerns or emotions. The typical needs for support were not solely linked to the medical, psychosocial and practical topics. Conclusion Different needs to express instrumental concerns and emotions throughout the disease trajectory are categorised. These needs provide input for developing interventions to support concern expression.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cancer patients' needs for support in expressing instrumental concerns and emotions

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…Patient coaching and/or question prompt-lists have been shown to help engage patients in care decisions, improve understanding [50–52] and potentially promote prognostic discussions. [53,54] If our intervention proves successful, combining IC video tools with question prompt lists or audio-recordings could be examined.…”

Section: Resultsmentioning

confidence: 99%

A stakeholder-driven approach to improve the informed consent process for palliative chemotherapy

Enzinger

Wind

Frank

et al. 2017

Patient Education and Counseling

View full text Add to dashboard Cite

Objective Patients often anticipate cure from palliative chemotherapy. Better resources are needed to convey its risks and benefits. We describe the stakeholder-driven development and acceptability testing of a prototype video and companion booklet supporting informed consent (IC) for a common palliative chemotherapy regimen. Methods Our multidisciplinary team (researchers, advocates, clinicians) employed a multistep process of content development, production, critical evaluation, and iterative revisions. Patient/clinician stakeholders were engaged throughout using stakeholder advisory panels, featuring their voices within the intervention, conducting surveys and qualitative interviews. A national panel of 57 patient advocates, and 25 oncologists from nine US practices critiqued the intervention and rated its clarity, accuracy, balance, tone, and utility. Participants also reported satisfaction with existing chemotherapy IC materials. Results Few oncologists (5/25, 20%) or advocates (10/22, 45%) were satisfied with existing IC materials. In contrast, most rated our intervention highly, with 89–96% agreeing it would be useful and promote informed decisions. Patient voices were considered a key strength. Every oncologist indicated they would use the intervention regularly. Conclusion Our intervention was acceptable to advocates and oncologists. A randomized trial is evaluating its impact on the chemotherapy IC process. Practice Implications Stakeholder-driven methods can be valuable for developing patient educational interventions.

show abstract

“…The rationale for combining the scores from each of the seven patient decision aids provided another outcome for data analysis, to attempt to identify any broad areas where patient decision aids within end-of-life care collectively may be lacking to support patient needs. The 'collective scores' were allocated to one of the three following categories, to represent the extent to which the patient decision aids collectively addressed each 'addressable' patient need: 'sufficient' (score: [22][23][24][25][26][27][28], 'variable' (score: [15][16][17][18][19][20][21], or 'insufficient' (score: 7-14).…”

Section: Search Two -Data Extraction Synthesis and Analysis (Objectimentioning

confidence: 99%

Do published patient decision aids for end-of-life care address patients’ decision-making needs? A systematic review and critical appraisal

et al. 2019

View full text Add to dashboard Cite

Background: Many decisions are made by patients in their last months of life, creating complex decision-making needs for these individuals. Identifying whether currently existing patient decision aids address the full range of these patient decision-making needs will better inform end-of-life decision support in clinical practice. Aims and design: This systematic review aimed to (a) identify the range of patients’ decision-making needs and (b) assess the extent to which patient decision aids address these needs. Data sources: MEDLINE, PsycINFO and CINAHL electronic literature databases were searched (January 1990–January 2017), supplemented by hand-searching strategies. Eligible literature reported patient decision-making needs throughout end-of-life decision-making or were evaluations of patient decision aids. Identified decision aid content was mapped onto and assessed against all patient decision-making needs that were deemed ‘addressable’. Results: Twenty-two studies described patient needs, and seven end-of-life patient decision aids were identified. Patient needs were categorised, resulting in 48 ‘addressable’ needs. Mapping needs to patient decision aid content showed that 17 patient needs were insufficiently addressed by current patient decision aids. The most substantial gaps included inconsistent acknowledgement, elicitation and documentation of how patient needs varied individually for the level of information provided, the extent patients wanted to participate in decision-making, and the extent they wanted their families and associated healthcare professionals to participate. Conclusion: Patient decision-making needs are broad and varied. Currently developed patient decision aids are insufficiently addressing patient decision-making needs. Improving future end-of-life patient decision aid content through five key suggestions could improve patient-focused decision-making support at the end of life.

show abstract

Promoting End-of-Life Discussions in Advanced Cancer: Effects of Patient Coaching and Question Prompt Lists

Cited by 79 publications

References 34 publications

Cancer patients' needs for support in expressing instrumental concerns and emotions

Cancer patients' needs for support in expressing instrumental concerns and emotions

A stakeholder-driven approach to improve the informed consent process for palliative chemotherapy

Do published patient decision aids for end-of-life care address patients’ decision-making needs? A systematic review and critical appraisal

Contact Info

Product

Resources

About