Advance Care Planning and Goals of Care Discussion: Barriers from the Perspective of Medical Residents

Laiane Moraes Dias (), Mayra de Almeida Frutig, Mirella Rebello Bezerra, Williams Fernandes Barra, Luísa Castro and Francisca Rego
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Laiane Moraes Dias: Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
Mayra de Almeida Frutig: Institute of Cancer of São Paulo-ICESP, São Paulo 01246-000, SP, Brazil
Mirella Rebello Bezerra: Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
Williams Fernandes Barra: João de Barros Barreto University Hospital, Federal University of Pará, Belém 66075-110, PA, Brazil
Luísa Castro: Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
Francisca Rego: Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal

IJERPH, 2023, vol. 20, issue 4, 1-13

Abstract: Background: Advance care planning (ACP) and goals of care discussion involve the exploration of what is most important to a person to prepare for health-care decision making. Despite their well-established benefits, they are still not frequently performed in clinical oncology practice. This study aims to describe the barriers to discussion goals of care with oncology patients from the perspective of medical residents. Methods. This cross-sectional and qualitative study applied the “Decide-Oncology” questionnaire, adapted to Portuguese language, to assess barriers to goals of care discussion among medical residents from three university hospitals in Brazil. Residents were asked to rank the importance of various barriers to discuss goals of care (ranging from 1—extremely unimportant to 7—extremely important). Results: Twenty-nine residents answered the questionnaire (30.9%). The most reported barriers were related to patients and their families’ difficulty in understanding and accepting the diagnosis and the prognosis as well as patients’ desire to receive full active treatment. Furthermore, the physician and external factors such as lack of training and lack of time to have these conversations were also very important barriers. The identification of the key barriers that limit the discussion of ACP and early palliative care referrals can certainly help to prioritize the next steps for future studies aimed at improving ACP and goals of care discussions.

Keywords: communication skills; oncology; medical residency; advance care planning (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:20:y:2023:i:4:p:3239-:d:1066372

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