Dados do Trabalho

Título

WHEN AND HOW TO DISCUSS ABOUT PALLIATIVE CARE AND ADVANCE CARE PLANNING WITH CANCER PATIENTS: A MIXED-METHODS STUDY

Introdução

Engaging in conversations about palliative care (PC) and advance care planning (ACP) with cancer patients requires awareness, timing and effective communication strategies.

Objetivo e Método

To identify the patients who are most likely to participate in discussions about palliative care and advance care planning, and to determine their preferred timing and approach of discussion.
Methods: The study included women aged 18–75 years diagnosed with breast cancer. In the quantitative phase, sociodemographic and clinical characteristics, knowledge, decision-making, and stigmas were evaluated. The qualitative phase included questions about patients’ understanding, timing, and method of discussing PC and ACP.

Resultados

In Phase 1, a total of 115 participants were included, with 53.04% completing both phases and 46.96% declining further participation. Those who completed both phases exhibited higher rates of marriage and educational attainment, while those who declined Phase 2 had a higher prevalence of advanced-stage cancer and palliative treatment. Completion of both phases was associated with a greater knowledge of reality and increased awareness of PC and ACP. Furthermore, the qualitative analysis revealed 5 convergent themes: timing, demystification, patient empowerment, misconception elimination, and open communication. These themes informed the development of a conceptual model that provides a framework for discussing PC and ACP with patients at different stages of cancer diagnosis and treatment, highlighting appropriate and inappropriate approaches and timing.

Conclusão/Considerações finais

Conclusion: Early discussion is beneficial, but withholding information or infringing on autonomy should be avoided. The study reveals that highly educated individuals tend to be more receptive to these discussions. However, patients with late-stage cancer tend to decline participation. Patients value open communication, demystification of PC, and empowering discussions that eliminate misunderstandings. Efforts should be made to reach patients with limited familiarity, particularly those with late-stage cancer, to increase their receptiveness to enable well-informed decision-making.

Referências

(1) Rocha Tardelli N et al. Advance Care Planning in Brazil. Z Evid Fortbild Qual Gesundhwes. 2023 Aug;180:43-49.
(2) McIlfatrick S et al. Examining public knowledge, attitudes and perceptions towards palliative care: a mixed method sequential study. BMC Palliat Care. 2021 Mar 17;20(1):44.

Palavras Chave

Advance Care Planning; Palliative Care; Câncer