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- Title
"It Gives Me Peace of Mind So I Can Focus on Healing": Views on Advance Care Planning for Older Surgical Patients.
- Authors
Colley, Alexis; Broering, Jeannette; Lee, Katherine; Lin, Joseph A.; Pierce, Logan; Finlayson, Emily; Sudore, Rebecca L.; Wick, Elizabeth C.
- Abstract
Introduction: The period of time before an elective operation may be an opportune time to engage older adults in advance care planning (ACP). Past interventions have not been readily incorporated into surgical workflows leaving a need for ACP tools that are generalizable, easy to implement, and effective. Design: This is a qualitative study. Setting and Subjects: Older adults with a history of cancer and a recent major operation were recruited through their surgical oncologist at a tertiary medical center in the United States. Interviews were conducted to determine how to adapt the validated PrepareForYourCare.org ACP program with electronic health record prompts for the perioperative setting and openness to introducing ACP during a presurgical visit. We used qualitative content analysis to determine themes. Results: Eight themes were identified: (1) ACP as static and private, (2) people expected a prompt, (3) family trusted to do the "right" thing, (4) lack of relationship or comfort with providers, (5) a team-based approach can be helpful, (6) surgeon's expertise (e.g., prognosis and surgical risk), (7) ACP belongs on the surgical checklist, and (8) patients would welcome a conversation starter. Discussion: Older surgical patients are interested in engaging with ACP, particularly if prompted, and believe it has a place on the preoperative "checklist." Conclusions: To effectively engage patients with ACP, a combination of routine prompts by the health care team and patient-centered follow-up may be required.
- Subjects
UNITED States; TUMOR surgery; TEAMS in the workplace; SURGERY; PATIENTS; QUALITATIVE research; RESEARCH funding; INTERVIEWING; CONTENT analysis; TERTIARY care; PREOPERATIVE care; THEMATIC analysis; FAMILY attitudes; PHYSICIAN-patient relations; COMMUNICATION; ADVANCE directives (Medical care); PATIENT participation; PATIENTS' attitudes; OLD age
- Publication
Journal of Palliative Medicine, 2024, Vol 27, Issue 5, p667
- ISSN
1096-6218
- Publication type
Article
- DOI
10.1089/jpm.2023.0589