Many patients play an active role in determining their cancer treatments, and the communication of medical information influences patient decision-making. This study examined participants' preferences between various methods of communicating quantitative risks and benefits of adjuvant chemotherapy. Using clinical vignettes, participants were first asked to decide whether or not to endorse chemotherapy and were subsequently asked about their preferences for the methods used to communicate the risks and benefits. Participants preferred the absolute survival benefit method over negatively framed methods, such as relative or absolute risk reduction. We also present analysis of qualitative data which supports the conclusions drawn from quantitative analyses. In summary, the absolute survival benefit was shown to be the superior method of communicating quantitative risks and benefits of chemotherapy. Failure to use clear and concise methods of communicating quantitative risk and benefit information may compromise efforts to obtain informed consent for treatment.

The use of team-based models of care is widely regarded as a mechanism for enhancing the delivery of high-quality care, especially at the end of life. Active collaboration to promote effective coordination and delivery of person-centered care is an integral part of the team-based model that is the focus of this article.

No abstract

serious illnesses and how it may pertain to patients with LVADs including loss of control, self-image, dependency, social stigma, anger, abandonment, isolation and thinking about death. Tools to manage psychosocial stressors such as local support groups and the implementation of therapeutic metaphors (the Labyrinth and Butterfly Release Life Transformation Celebration for LVAD patients) will be described in detail. We will discuss the incorporation of our palliative care team in assisting with management of LVAD patients in collaboration with the advanced heart failure team including advanced care planning and assessing psychosocial factors prior to implantation. Through brief case examples from our experience, we will discuss how spirituality has played a role in decision-making for patients as they view their heart as a sacred entity.

No abstract