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Trained facilitators' experiences with structured advance care planning conversations in oncology
- Source :
- BMC Cancer, Vol 19, Iss 1, Pp 1-13 (2019), BMC cancer, vol. 19, pp. 1-13, 2019., BMC CANCER, BMC Cancer, 19(1). BioMed Central, BMC Cancer, BMC Cancer, 19(1):1026. BioMed Central Ltd., 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 M, 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 K, Ozbic, P, Grønvold, M & Johnsen, A T 2019, ' Trained facilitators' experiences with structured advance care planning conversations in oncology : an international focus group study within the ACTION trial ', B M C Cancer, vol. 19, 1026 . https://doi.org/10.1186/s12885-019-6170-7
- Publication Year :
- 2019
- Publisher :
- BioMed Central, 2019.
-
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.
- 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
Subjects
Details
- Language :
- English
- ISSN :
- 14712407
- Database :
- OpenAIRE
- Journal :
- BMC Cancer, Vol 19, Iss 1, Pp 1-13 (2019), BMC cancer, vol. 19, pp. 1-13, 2019., BMC CANCER, BMC Cancer, 19(1). BioMed Central, BMC Cancer, BMC Cancer, 19(1):1026. BioMed Central Ltd., 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 M, 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 K, Ozbic, P, Grønvold, M & Johnsen, A T 2019, ' Trained facilitators' experiences with structured advance care planning conversations in oncology : an international focus group study within the ACTION trial ', B M C Cancer, vol. 19, 1026 . https://doi.org/10.1186/s12885-019-6170-7
- Accession number :
- edsair.doi.dedup.....90088ef871a8311cd9b58ee37fe7ada1