Advance Care Planning Conversations in the Oncology Setting: Tips from the Experts

Nortjé, Nico; Stepan, Karen

doi:10.1007/s13187-019-01631-1

Cited by 6 publications

(4 citation statements)

References 10 publications

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“…These findings could be explained by previous research that suggests that, although clinicians are educated about ACP, they are often afraid of talking about death and may forget to initiate ACP conversations with patients in the rush of clinical practice. [36][37][38][39] Approximately 19% of ACP tweets recognized DNR/ DNI orders as a form of discrimination during the pandemic and were associated with the most negative sentiment. These findings suggest that public reservations about DNR/DNI may be rooted in fear of biased treatment of groups such as the elderly or people with disabilities.…”

Section: Discussionmentioning

confidence: 99%

Perceptions of Life Support and Advance Care Planning During the COVID-19 Pandemic

Patel

Gereta

Blanton

et al. 2022

Chest

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Background The COVID-19 pandemic has presented new challenges surrounding end-of-life planning and has been associated with increased online discussion about life support. Research Question How has online communication about advance care planning (ACP) and specific life-sustaining interventions (LSIs) changed during the pandemic? Study Design and Methods Conversations on Twitter containing references to LSIs (e.g., ‘ECMO’) or ACP (e.g., ‘DNR/DNI’) were collected from January 2019 to May 2021. User account metadata was used to predict user demographic information and classify users as either organizations, individuals, clinicians, or influencers. We compared the number of impressions across these user categories and analyzed the content of tweets using natural language processing models to identify topics of discussion and associated emotional sentiment. Results There were 202,585 unique tweets about LSIs and 67,162 unique tweets about ACP. Users who were younger, men, or influencers were more likely to discuss LSIs online. Tweets about LSIs were associated with more positive emotional sentiment scores than tweets about ACP (LSIs: 0.3, ACP: -0.2; P < 0.001). Among tweets about ACP, most contained personal experiences related to the death of loved ones (27%) or discussed discrimination through DNR orders directed at the elderly and disabled (19%). Personal experiences had the greatest retweet-to-tweet-ratio (4.7), indicating high levels of user engagement. Tweets about discrimination contained the most negative net sentiment score (-0.5). Interpretation The observed increase in tweets regarding LSIs and ACP suggests that Twitter was consistently utilized to discuss treatment modalities and preferences related to intensive care during the pandemic. Future interventions to increase online engagement with ACP may consider leveraging influencers and personal stories. Finally, we identified DNR-related discrimination as a commonly held public fear, which should be further explored as a barrier to ACP completion and can be proactively addressed by clinicians during bedside goals-of-care discussions.

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Section: Discussionmentioning

confidence: 99%

Perceptions of Life Support and Advance Care Planning During the COVID-19 Pandemic

Patel

Gereta

Blanton

et al. 2022

Chest

Self Cite

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“…In Japan [29] and Brazil [24], the opportunity for such training was the main factor associated with ACP discussion initiation, even though most participants in the latter study did not consider their training levels to be high [24]. In the United States, a study highlighted that HCPs perception of the value of ACP communication greatly influenced their initiation of such conversations [27].…”

Section: Key Pointsmentioning

confidence: 91%

“…Thirty-eight studies [15–52] and three reviews were identified [6 ▪ ,8 ▪▪ ,13 ▪▪ ]. Studies were heterogeneous in terms of cancer care contexts, population size and characteristics, research designs, and assessment methods (Table 1).…”

Section: Literature Search and Samplementioning

confidence: 99%

“…Factors associated with ACP communication were allocated to five categories (based on ACP uptake [13 ▪▪ ] and communication in healthcare [14] models): ACP uptake-predisposing factors and barriers [15–23], ACP uptake-enabling factors and barriers [15,18,24,25,26 ▪ ,27–29], perceived need for ACP communication and barriers [15], ACP communication–enabling factors and barriers [17,18,23,25,26 ▪ ,30–38], and willingness to communicate about ACP [23,30–32]. Fourteen articles that were not included in these categories are reported in Table 1.…”

Section: Overview Of Factors Influencing Advance Care Planning Commun...mentioning

confidence: 99%

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Advance care planning in oncology: a scoping review and some recommendations

Libert,

Choucroun,

Razavi

et al. 2023

Current Opinion in Oncology

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Purpose of reviewCancer patients' communication with their relatives and healthcare professionals (HCPs) is essential for advance care planning (ACP). The purpose of this scoping review was to synthesize recent research findings about factors enabling cancer patients', their relatives', and physicians' communication about ACP, and to propose recommendations for future ACP implementation in cancer care. Recent findingsThis review confirmed the importance of aspects of the cancer care context (i.e., culture) as ACP uptakepredisposing and -enabling factors. It highlighted the difficulty of determining who should initiate ACP discussion, with which patients and at what time-points. It also highlighted a lack of consideration for socioemotional processes in the study of ACP uptake despite evidence that cancer patients', relatives' and physicians' discomforts that arise from communication about end-of-life and the wish to safeguard each other are main obstacles to ACP implementation.

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Enhancing Oncologists’ Comfort with Serious Illness Conversations: The Impact of Serious Illness Conversation Guide (SICG) Training

Adaji,

Johnson,

George

et al. 2024

J Canc Educ

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Advance Care Planning Conversations in the Oncology Setting: Tips from the Experts

Cited by 6 publications

References 10 publications

Perceptions of Life Support and Advance Care Planning During the COVID-19 Pandemic

Perceptions of Life Support and Advance Care Planning During the COVID-19 Pandemic

Advance care planning in oncology: a scoping review and some recommendations

Enhancing Oncologists’ Comfort with Serious Illness Conversations: The Impact of Serious Illness Conversation Guide (SICG) Training

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