Timing of advance care planning in patients with advanced cancer: Analysis of ACTION data

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling Pub Date : 2025-03-24 DOI:10.1016/j.pec.2025.108761

Tingting Zhu , Judith AC Rietjens , Johannes J.M. van Delden , Luc Deliens , Agnes van der Heide , Anna Thit Johnsen , Francesca Ingravallo , Urška Lunder , Nancy J. Preston , Jane Seymour , Ida J. Korfage

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引用次数: 0

Abstract

Objective

To explore the experiences of patients with advanced cancer regarding the timing of ACP.

Methods

This secondary analysis used data from the ACTION cluster-randomized clinical trial. 288 patients with advanced lung or colorectal cancer, WHO performance status 0–3, and with a minimum life expectancy of 3 months were included in this analysis.

Results

The mean time between patients’ cancer diagnosis and the first ACP conversation was 15.3 months (SD:19.4). The average duration from current cancer stage diagnosis to the first conversation was 8.9 months (SD:10.7). The timing of the conversation was perceived as “just right” by 217 (75.3 %) of the patients. Patients who perceived the timing as “too early” were more recently diagnosed with cancer (9.1 months) or with their current cancer stage (5.7 months) than those who did not. Patients perceiving the timing as “too late” had shorter estimated survival times.

Conclusion

Patients with advanced cancer may benefit from earlier ACP than what is currently typically initiated in clinical practice.

Practice implications

When initiating ACP conversations, several aspects should be considered, including patients’ gender, their socio-cultural environment, and their ability to perform daily activities, with or without limitations.

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晚期癌症患者提前护理计划的时机：ACTION数据分析

目的探讨晚期肿瘤患者选择ACP时机的经验。方法采用ACTION集群随机临床试验的数据进行二次分析。288例晚期肺癌或结直肠癌患者，WHO评分0-3，最低预期寿命为3个月。结果患者确诊至首次ACP对话平均时间为15.3个月（SD:19.4）。从目前的癌症阶段诊断到第一次谈话的平均持续时间为8.9个月（标准差：10.7）。217名（75.3 %）患者认为谈话的时机“刚刚好”。认为时间“太早”的患者比不认为时间“太早”的患者最近被诊断出癌症（9.1个月）或目前的癌症阶段（5.7个月）。认为时机“太晚”的患者估计生存时间较短。结论早期ACP治疗对晚期肿瘤患者有较好的疗效。当启动ACP对话时，应考虑几个方面，包括患者的性别，他们的社会文化环境，以及他们进行日常活动的能力，有或没有限制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Patient Education and Counseling 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.60

自引率

11.40%

发文量

384

审稿时长

46 days

期刊介绍： Patient Education and Counseling is an interdisciplinary, international journal for patient education and health promotion researchers, managers and clinicians. The journal seeks to explore and elucidate the educational, counseling and communication models in health care. Its aim is to provide a forum for fundamental as well as applied research, and to promote the study of organizational issues involved with the delivery of patient education, counseling, health promotion services and training models in improving communication between providers and patients.