The role of relatives in decisions concerning life-prolonging treatment in patients with end-stage malignant disorders: informants, advocates or surrogate decision-makers?

Hauke, Daniela; Reiter-Theil, Stella; Hoster, Eva; Hiddemann, Wolfgang; Winkler, Eva C.

doi:10.1093/annonc/mdr019

Cited by 58 publications

(45 citation statements)

References 28 publications

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“…Effective communication skills can be improved with training and transferred into a clinical setting having an enduring impact 18; 19. Also, in this survey there appears to be a mismatch between the 50% of Italian oncologists that are ready to thoroughly inform the patient on the prognosis and 90% that are prepared to talk about this issue with the family - this is clearly a different handling than in other countries 20. This could reflect a cultural background, as well as a lack of training in communication skills that is strongly advocated by most medical oncologists.…”

Section: Discussionmentioning

confidence: 81%

Early Integration of Palliative Care in Oncology Practice: Results of the Italian Association of Medical Oncology (AIOM) Survey

et al. 2016

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Background: Early integration of palliative care in oncology practice (“simultaneous care”, SC) has been shown to provide better care resulting in improved quality-of-life and also survival. We evaluated the opinions of Italian Association of Medical Oncology (AIOM) members. Patients and methods: A 37-item questionnaire was delivered to 1119 AIOM members. Main areas covered were: social, ethical, relational aspects of disease and communication, training, research, organizational and management models in SC. Three open questions explored the definition of Quality of Life, Medical Oncologist and Palliative Care. Results: Four hundred and forty-nine (40.1%) medical oncologists returned the questionnaires. Forty-nine percent stated they address non-curability when giving a diagnosis of metastatic tumor, and 43% give the information only to patients who clearly ask for it. Fifty-five percent say the main formative activity in palliative medicine came from attending meetings and 90% agree that specific palliative care training should be part of the core curriculum in oncology. Twenty-two percent stated they consulted guidelines for symptom management, 45% relied upon personal experience and 26% make a referral to a palliative care specialist. Seventy-four percent were in favor of more research in palliative medicine. An integration between Units of Oncology and Palliative Care Services early in the course of advanced disease was advocated by 86%. Diverse and multifaceted definitions were given for the concepts of Quality of Life, Palliative Care and Medical Oncologist. Conclusion: SC is felt as an important task, as well as training of medical oncologists in symptom management and research in this field.

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Section: Discussionmentioning

confidence: 81%

Early Integration of Palliative Care in Oncology Practice: Results of the Italian Association of Medical Oncology (AIOM) Survey

et al. 2016

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“…In das Erkrankungsgeschehen sind Angehörige sowohl als Unterstützer, Pflegende und/oder als Mitbetroffene einzubeziehen [9,10]. Am Therapieentscheidungsprozess partizipieren Angehörige zumeist implizit, aber auch explizit, z.…”

Section: Therapiezielfindung Und Kriterien Der Entscheidungsfindungunclassified

Therapiezielfindung und Kriterien der Entscheidungsfindung

Alt-Epping¹,

Bausewein²,

Voltz³

et al. 2020

Palliativmedizin

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“…A qualitative interview study with 38 patients with advanced cancer and their oncologists (n = 21) found that patients and oncologists shared similar views about family involvement in such decisions, highlighting the importance for patients' understanding of their disease and family emotional support [42] . However, clinical evidence demonstrates that oncologists are still reluctant to involve family or else involve them too late in the course of the disease [43][44][45] .…”

Section: Patients' Preferences Regarding Family Involvement In Decisimentioning

confidence: 99%

Patients' Preferences in Non-Curable Cancer Disease

Laryionava

Winkler²

2019

Oncol Res Treat

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Eliciting and integrating patients' preferences in decision-making in palliative oncology is an important criterion for the quality of end-of-life care. It is an essential prerequisite in supporting the integrity of patients' decision-making process, enhancing patients' right to self-determination and facilitating patients' autonomy. In this review we summarize the data on: (1) patients' preference for a decisional model in advanced cancer, (2) patients' preferences for quality versus length of life and the enrollment of patients in early-phase clinical studies, and (3) preferences for caregiver involvement in decision-making. Timely assessment of patients' preferences enables advance care planning with respect to considering patients' values, discussing therapy goals and planning for patients' end-of-life care. It helps avoiding overtreatment near the end of life and giving care that is aligned to patients' wishes and family capacities.

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The role of relatives in decisions concerning life-prolonging treatment in patients with end-stage malignant disorders: informants, advocates or surrogate decision-makers?

Abstract: If relatives are to play an important part in EOL decision making, we must devise strategies to recognise their potential as patients' advocates as well as their own needs.

Cited by 58 publications

References 28 publications

Early Integration of Palliative Care in Oncology Practice: Results of the Italian Association of Medical Oncology (AIOM) Survey

Early Integration of Palliative Care in Oncology Practice: Results of the Italian Association of Medical Oncology (AIOM) Survey

Therapiezielfindung und Kriterien der Entscheidungsfindung

Patients' Preferences in Non-Curable Cancer Disease

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