Strategies to Understand What Matters to Advanced Cancer Patients in Advance Care Planning: A Qualitative Study Using the Lifeline Interview Method

Abstract

Little is known about how health care providers should conduct advance care planning to identify the values of East Asian patients who have serious illnesses. This study aims to explore whether and how patients from an East Asian culture and with advanced cancer express their values and priorities when nurses utilize the lifeline interview method to enable patients to reflect on their life trajectories and if it can bridge advance care planning discussions. Data obtained from individual, semistructured interviews of 11 patients with advanced lung cancer were analyzed using qualitative content analysis. Seven main themes were identified: (1) treatment and essential elements to maintaining everyday life, (2) beliefs regarding and support for being "myself", (3) emotional ups and downs in response to physical condition, (4) competency to cope, ( 5) what I want to do "now" to achieve my goals, (6) goals that bring hope for life, and (7) wishes and preferences for end-of-life decision-making. Results suggest that the lifeline interview method is an excellent means for nurses and other health care professionals to elicit patients' values and priorities. Moreover, it bridges advance care planning discussions to reflect on what matters to patients in future palliative care.

Communication in Cancer Care in Asia: A Narrative Review

“…While tools for decision support and goals-of-care discussions may be effective in improving the quality of patient-HCP communication in Asia, strategies such as the life-line interview method (ie, an integrative method for eliciting in-depth autobiographical information about life history and future expectations related to the emotions of each significant life event in an individual's life) 91 to engage patients in exploring their values should be incorporated to overcome difficulties experienced by HCPs. 8 Finally, strategies to overcome limitations in current practices when family members request nondisclosure of bad news to their loved one include the following: exploring reasons of family encouraging nondisclosure; flipping the roles of the patient and the family and asking what the family members would want if they were the patients and explaining what the patient may want to do with proper disclosure; discussing values, goals, and preferences by addressing patients' and family members' concerns and emotions; and facilitating communication between patients and family members.…”