Cancer advance care planning: development of a screening tool
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Le résumé fourni par la source
Objectives Advance care discussions are a useful communication tools for medical preferences and beneficial for shared decision-making processes in hospital settings. The present study developed the first screening tool for need for advance care planning (ACP). Methods In phase 1 (n=92), items were evaluated using feasibility analysis and item reduction. In phase 2 (n=201), reduced screening items were analysed for predictive value of need for ACP. Statistical analysis included receiver-operating characteristics analysis (area under the curve>0.80), optimal cut-off based on sensitivity and specificity, interpretation of OR and construct validity using correlation with death anxiety, communication avoidance within families and trust based on the relationship with the treating physician. Results Participants in both phases were approximately 60 years old with non-curative prognosis. After item reduction, predictive values of four possible items with good item difficulty and discrimination were compared for mild, moderate and great levels of death anxiety. A two-item combination ofI am burdened by thoughts of an unfavourable course of the diseaseandI am burdened by the feeling of being ill-prepared for the end of lifeshowed best prediction of death anxiety and communication avoidance. Clinical cut-off at sum-score ≥6 was of high sensitivity (95%) and specificity (81%). Previous use of social support and readiness for ACP was related to higher chance of interest in ACP. Conclusion Screening for need of ACP is possible with two objective items and one subjective item. Positive screening therefore indicates when to offer ACP discussions and provides routine estimation of ACP need in clinical practice.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Cancer advance care planning: development of a screening tool
- Date Crossref
- 18/11/2023
- Éditeur
- BMJ
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Philipps University of Marburg pays non établi dans la noticeUniversité ou école supérieure
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Universitätsklinikum Gießen und Marburg pays non établi dans la noticeÉtablissement de santé
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Zimmer Biomet (Germany) pays non établi dans la noticeEntreprise
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Ruhr University Bochum Department of Medical Informatics pays non établi dans la noticeUniversité ou école supérieure
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Philipps-University Marburg Department of Clinical Psychology and Psychotherapy pays non établi dans la noticeUniversité ou école supérieure
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Department of Psychology pays non établi dans la noticeInstitution
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University Hospital Giessen and Marburg Department of Neurology pays non établi dans la noticeUniversité ou école supérieure
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University Hospital of Giessen and Marburg Department of Haematology pays non établi dans la noticeUniversité ou école supérieure
Philipps University of Marburg, Universitätsklinikum Gießen und Marburg et Zimmer Biomet (Germany), avec 5 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.