https://scholars.lib.ntu.edu.tw/handle/123456789/517889
標題: | Shared decision making with oncologists and palliative care specialists effectively increases the documentation of the preferences for do not resuscitate and artificial nutrition and hydration in patients with advanced cancer: A model testing study | 作者: | HSIEN-LIANG HUANG JAW-SHIUN TSAI CHIEN-AN YAO SHAO-YI CHENG WEN-YU HU TAI-YUAN CHIU |
公開日期: | 2020 | 出版社: | BioMed Central Ltd. | 卷: | 19 | 期: | 1 | 起(迄)頁: | 17 | 來源出版物: | BMC Palliative Care | 摘要: | Background: Communication in do not resuscitate (DNR) and artificial nutrition and hydration (ANH) at the end of life is a key component of advance care planning (ACP) which is essential for patients with advanced cancer to have cares concordant with their wishes. The SOP model (Shared decision making with Oncologists and Palliative care specialists) aimed to increase the rate of documentation on the preferences for DNR and ANH in patients with advanced cancer. Methods: The SOP model was implemented in a national cancer treatment center in Taiwan from September 2016 to August 2018 for patients with advanced cancer visiting the oncology outpatient clinic. The framework was based on the model of shared decision making as "choice talk" initiated by oncologists with "option talk" and "decision talk" conducted by palliative care specialists. Results: Among 375 eligible patients, 255 patients (68%) participated in the model testing with the mean age of 68.5 ± 14.7 years (mean ± SD). Comparing to 52.3% of DNR documentation among patients with advanced cancer who died in our hospital, the rate increased to 80.9% (206/255) after the decision talk in our model. Only 6.67% (n = 17) of the participants documented their preferences on ANH after the model. A worse Eastern Cooperative Oncology Group Performance Status was the only statistically significant associating factor with a higher rate of DNR documentation in the multiple logistic regression model. Conclusions: The SOP model significantly increased the rate of DNR documentation in patients with advanced cancer in this pilot study. Dissemination of the model could help the patients to receive care that is concordant with their wishes and be useful for the countries having laws on ACP. ? 2020 The Author(s). |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85079010644&doi=10.1186%2fs12904-020-0521-7&partnerID=40&md5=e0dae9affe38c5f85a68c4d717a7f076 https://scholars.lib.ntu.edu.tw/handle/123456789/517889 |
ISSN: | 1472-684X | DOI: | 10.1186/s12904-020-0521-7 | SDG/關鍵字: | advance care planning; advanced cancer; aged; Article; artificial feeding; cancer mortality; controlled study; do not resuscitate order; female; human; hydration; logistic regression analysis; major clinical study; male; medical documentation; medical specialist; oncologist; palliative therapy; pilot study; shared decision making; Taiwan; trend study; chi square distribution; documentation; interdisciplinary communication; middle aged; neoplasm; oncologist; palliative therapy; patient preference; procedures; psychology; resuscitation; very elderly; Aged; Aged, 80 and over; Chi-Square Distribution; Decision Making, Shared; Documentation; Female; Humans; Interdisciplinary Communication; Male; Middle Aged; Neoplasms; Oncologists; Palliative Care; Patient Preference; Pilot Projects; Resuscitation Orders; Taiwan |
顯示於: | 醫學系 |
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