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Your search keyword '"Zwakman, M."' showing total 3 results
Start Over Author "Zwakman, M." Topic qualitative research
3 results on '"Zwakman, M."'

1. Patient and family caregiver perspectives of Advance Care Planning: qualitative findings from the ACTION cluster randomised controlled trial of an adapted respecting choices intervention.

Author

Pollock, K., Bulli, F., Caswell, G., Kodba-Čeh, H., Lunder, U., Miccinesi, G., Seymour, J., Toccafondi, A., van Delden, J. J. M., Zwakman, M., Rietjens, J., van der Heide, A., and Kars, M.

Subjects
CAREGIVER attitudes, TERMINAL care, LIBERTY, BURDEN of care, PATIENTS' attitudes, ADVANCE directives (Medical care), TREATMENT effectiveness, QUALITATIVE research, RANDOMIZED controlled trials, RESPONSIBILITY, CANCER patients, DECISION making, RESEARCH funding, RESPECT
Abstract

Advance Care Planning (ACP) is widely regarded as a component of good end-of-life care. However, findings from a qualitative international study of patient and family caregiver attitudes and preferences regarding ACP highlight participants' ambivalence towards confronting the future and the factors underlying their motivation to accept or defer anticipatory planning. They show how ACP impacts on, and can be determined by, relationships between patients and their family caregivers. Although some patients may welcome the chance to engage in ACP a tendency towards either therapeutic optimism or fatalism can limit its perceived appeal or benefit. The focus on individual autonomy as an ethical principle underlying ACP does not resonate with real world settings. Many patients naturally orient to share responsibility and decision making within the network of significant others in which they are embedded, rather than exert unfettered freedom of 'choice'. [ABSTRACT FROM AUTHOR]

Published
2024
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2. Trained facilitators' experiences with structured advance care planning conversations in oncology

Author

Zwakman, M., Pollock, K., Bulli, F., Caswell, G., Cerv, B., van Delden, J. J. M., Deliens, L., van der Heide, A., Jabbarian, L. J., Koba-Ceh, H., Lunder, U., Miccinesi, G., Arnfeldt, C. A. Moller, Seymour, J., Toccafondi, A., Verkissen, M. N., Kars, M. C., Korfage, I. J., Rietjens, J. A. C., Polinder, S., Billekens, P. F. A., Eecloo, K., Faes, K., Wilcock, A., Bramley, L., Payne, S., Preston, N., Dunleavy, L., Sowerby, E., Ingravallo, F., Carreras, G., Gorini, G., Simonic, A., Mimic, A., Ceh, H. Kodba, Ozbic, P., Grønvold, M., Johnsen, A. Thit, Family Medicine and Chronic Care, End-of-life Care Research Group, Faculty of Medicine and Pharmacy, and Public Health

Subjects
Oncology, Advance care planning, Cancer Research, Lung Neoplasms, Experiences, pomočnik pri načrtovanju oskrbe, Emotions, ACTION study, respecting choices, Medical Oncology, GOALS, patients, 0302 clinical medicine, experience, Cultural diversity, Adaptation, Psychological, Health care, rak, Medicine and Health Sciences, facilitator, 030212 general & internal medicine, media_common, Cancer, Facilitator, Communication, Professional-Patient Relations, Focus Groups, bolniki, GENERAL-PRACTITIONERS, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, 3. Good health, Europe, 030220 oncology & carcinogenesis, raziskava ACTION, spoštovanje odločitev, Colorectal Neoplasms, Psychology, Life Sciences & Biomedicine, Research Article, medicine.medical_specialty, Health Personnel, media_common.quotation_subject, education, Self-concept, lcsh:RC254-282, 03 medical and health sciences, PEOPLE, Internal medicine, Respecting choices, medicine, Genetics, Journal Article, Humans, udc:614.2, cancer, Conversation, Science & Technology, izkušnje, BARRIERS, business.industry, Focus group, Self Concept, business, Qualitative research
Abstract

Background In oncology, Health Care Professionals often experience conducting Advance Care Planning (ACP) conversations as difficult and are hesitant to start them. A structured approach could help to overcome this. In the ACTION trial, a Phase III multi-center cluster-randomized clinical trial in six European countries (Belgium, Denmark, Italy, the Netherlands, Slovenia, United Kingdom), patients with advanced lung or colorectal cancer are invited to have one or two structured ACP conversations with a trained facilitator. It is unclear how trained facilitators experience conducting structured ACP conversations. This study aims to understand how facilitators experience delivering the ACTION Respecting Choices (RC) ACP conversation. Methods A qualitative study involving focus groups with RC facilitators. Focus group interviews were recorded, transcribed, anonymized, translated into English, and thematically analysed, supported by NVivo 11. The international research team was involved in data analysis from initial coding and discussion towards final themes. Results Seven focus groups were conducted, involving 28 of in total 39 trained facilitators, with different professional backgrounds from all participating countries. Alongside some cultural differences, six themes were identified. These reflect that most facilitators welcomed the opportunity to participate in the ACTION trial, seeing it as a means of learning new skills in an important area. The RC script was seen as supportive to ask questions, including those perceived as difficult to ask, but was also experienced as a barrier to a spontaneous conversation. Facilitators noticed that most patients were positive about their ACTION RC ACP conversation, which had prompted them to become aware of their wishes and to share these with others. The facilitators observed that it took patients substantial effort to have these conversations. In response, facilitators took responsibility for enabling patients to experience a conversation from which they could benefit. Facilitators emphasized the need for training, support and advanced communication skills to be able to work with the script. Conclusions Facilitators experienced benefits and challenges in conducting scripted ACP conversations. They mentioned the importance of being skilled and experienced in carrying out ACP conversations in order to be able to explore the patients’ preferences while staying attuned to patients’ needs. Trial registration International Standard Randomised Controlled Trial Number registry 63110516 (ISRCTN63110516) per 10/3/2014.

Published
2019

3. Unraveling patients' readiness in advance care planning conversations: a qualitative study as part of the ACTION Study.

Author

Zwakman, M., Milota, M. M., van der Heide, A., Jabbarian, L. J., Korfage, I. J., Rietjens, J. A. C., van Delden, J. J. M., and Kars, M. C.

Subjects
*CONVERSATION analysis, *PREPAREDNESS, *MEDICAL personnel, *QUALITATIVE research, *COLORECTAL cancer, *RESEARCH, *CLINICAL trials, *RESEARCH methodology, *MEDICAL cooperation, *EVALUATION research, *ADVANCE directives (Medical care), *COMPARATIVE studies, *COMMUNICATION, *RESEARCH funding
Abstract

Purpose: Patients' readiness for advance care planning (ACP) is often considered a prerequisite for starting ACP conversations. Healthcare professionals' uncertainty about patients' readiness hampers the uptake of ACP in clinical practice. This study aims To determine how patients' readiness is expressed and develops throughout an ACP conversation.Methods: A qualitative sub-study into the ACTION ACP conversations collected as part of the international Phase III multicenter cluster-randomized clinical trial. A purposeful sample was taken of ACP conversations of patients with advanced lung or colorectal cancer who participated in the ACTION study between May 2015 and December 2018 (n = 15). A content analysis of the ACP conversations was conducted.Results: All patients (n = 15) expressed both signs of not being ready and of being ready. Signs of being ready included anticipating possible future scenarios or demonstrating an understanding of one's disease. Signs of not being ready included limiting one's perspective to the here and now or indicating a preference not to talk about an ACP topic. Signs of not being ready occurred more often when future-oriented topics were discussed. Despite showing signs of not being ready, patients were able to continue the conversation when a new topic was introduced.Conclusion: Healthcare professionals should be aware that patients do not have to be ready for all ACP topics to be able to participate in an ACP conversation. They should be sensitive to signs of not being ready and develop the ability to adapt the conversation accordingly. [ABSTRACT FROM AUTHOR]

Published
2021
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