Search

Your search keyword '"Rachel A. Rodenbach"' showing total 2 results
Start Over Author "Rachel A. Rodenbach"
2 results on '"Rachel A. Rodenbach"'

1. Relationships Between Advanced Cancer Patients' Worry About Dying and Illness Understanding, Treatment Preferences, and Advance Care Planning

Author

Thomas J. Smith, Yael Schenker, Rachel A. Rodenbach, Edward Chu, Douglas B. White, Robert M. Arnold, Marie Bakitas, and Andrew D. Althouse

Subjects
Advance care planning, medicine.medical_specialty, Palliative care, Multivariate analysis, media_common.quotation_subject, Context (language use), Article, Advance Care Planning, 03 medical and health sciences, 0302 clinical medicine, Neoplasms, medicine, Humans, 030212 general & internal medicine, General Nursing, media_common, Terminal Care, business.industry, Palliative Care, Odds ratio, Advanced cancer, Cross-Sectional Studies, Anesthesiology and Pain Medicine, 030220 oncology & carcinogenesis, Family medicine, Anxiety, Neurology (clinical), medicine.symptom, Worry, Advance Directives, business
Abstract

Context Patients with advanced cancer often worry about dying. Less is known about the role of worry in decision making regarding future care. Objectives To explore relationships between patients' worry about dying and their illness understanding, treatment preferences, and advance care planning (ACP). Methods This cross-sectional study used baseline data from a primary palliative care intervention trial. All participants had metastatic solid tumors. Using patients' response to I worry about dying from the Functional Assessment of Chronic Illness—Palliative Care survey instrument, univariate and multivariate analyses assessed associations with illness understanding, treatment preferences, and ACP. Results Of 672 patients, 47% reported worrying about dying not at all, whereas 9.7% worried quite a bit or very much. In regression analysis, compared with patients who reported not worrying about dying, those who reported high levels of worry were more likely to describe themselves as terminally ill (adjusted odds ratio [AOR] = 1.98; 95% CI = 1.10–3.54; P = 0.021) and prefer life-extending therapy over symptom-focused care (AOR = 2.61; 95% CI = 1.30–5.22; P = 0.007). They were less likely to have completed an advance directive (AOR = 0.49; 95% CI = 0.25–0.94; P = 0.032). The same relationships were seen using patients' response to I feel scared about my future from the Herth Hope Index. Conclusion Patients with advanced cancer who worry about dying are more likely to identify as terminally ill and desire life-extending treatment and are less likely to engage in ACP. Understanding how patients cope with worry and make medical decisions is important in providing quality care to these patients.

Published
2021
Full Text
View/download PDF

2. Promoting End-of-Life Discussions in Advanced Cancer: Effects of Patient Coaching and Question Prompt Lists.

Author

Rodenbach RA, Brandes K, Fiscella K, Kravitz RL, Butow PN, Walczak A, Duberstein PR, Sullivan P, Hoh B, Xing G, Plumb S, and Epstein RM

Subjects
Adult, Advance Care Planning, Aged, Attitude to Death, Female, Humans, Male, Middle Aged, Communication, Neoplasms psychology, Neoplasms therapy, Oncologists psychology, Physician-Patient Relations, Terminal Care methods, Terminal Care psychology
Abstract

Purpose To build on results of a cluster randomized controlled trial (RCT) of a combined patient-oncologist intervention to improve communication in advanced cancer, we conducted a post hoc analysis of the patient intervention component, a previsit patient coaching session that used a question prompt list (QPL). We hypothesized that intervention-group participants would bring up more QPL-related topics, particularly prognosis-related topics, during the subsequent oncologist visit. Patients and Methods This cluster RCT with 170 patients who had advanced nonhematologic cancer (and their caregivers) recruited from practices of 24 participating oncologists in western New York. Intervention-group oncologists (n = 12) received individualized communication training; up to 10 of their patients (n = 84) received a previsit individualized communication coaching session that incorporated a QPL. Control-group oncologists (n = 12) and patients (n = 86) received no interventions. Topics of interest identified by patients during the coaching session were summarized from coaching notes; one office visit after the coaching session was audio recorded, transcribed, and analyzed by using linear regression modeling for group differences. Results Compared with controls, more than twice as many intervention-group participants brought up QPL-related topics during their office visits (70.2% v 32.6%; P < .001). Patients in the intervention group were nearly three times more likely to ask about prognosis (16.7% v 5.8%; P =.03). Of 262 topics of interest identified during coaching, 158 (60.3%) were QPL related; 20 (12.7%) addressed prognosis. Overall, patients in the intervention group brought up 82.4% of topics of interest during the office visit. Conclusion A combined coaching and QPL intervention was effective to help patients with advanced cancer and their caregivers identify and bring up topics of concern, including prognosis, during their subsequent oncologist visits. Considering that most patients are misinformed about prognosis, more intensive steps are needed to better promote such discussions.

Published
2017
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results