Casemanagers Positioned as Key Advance Care Planning Conversationalists in Oncology Care: A Qualitative Interview Study on the Perspectives of Healthcare Professionals and Patients

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2025-09-04 DOI:10.1002/cam4.71195

Anouk Putker, Marieke Perry, Jelmer Chalkiopoulos, Annika Piek, Yvonne Engels, Evelien Kuip

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引用次数: 0

Abstract

Introduction

The increasing global cancer burden and advances in treatments have extended patients' life expectancy, leading to greater prognostic uncertainty and a higher demand for palliative care. Advance care planning (ACP) is essential in this context, ensuring that patients' future care aligns with their values and preferences. Oncology case managers, being nurses with specialized training, have emerged as key ACP conversationalists. This study explores the perspectives of healthcare professionals and patients on case managers as ACP conversationalists for advanced cancer patients.

Methods

A qualitative interview study was conducted with 12 patients who recently had an ACP conversation with their case managers and 12 healthcare professionals, including medical oncologists and case managers, at a university medical center in the Netherlands. Transcripts of semi-structured interviews were analyzed using inductive thematic analysis.

Results

Three main themes emerged: (1) Trust as the foundation for effective ACP, where patients valued the casemanagers' familiarity and accessibility; (2) ACP aligns with the competencies and tasks of the casemanager, as their communication skills and disease knowledge were seen as strengths; (3) Challenges related to responsibility around treatment decisions and the reluctance of medical oncologists to relinquish control of the conversation. Both patients and professionals recognized the importance of casemanagers having ACP conversations.

Conclusions

Casemanagers are well-positioned to lead ACP conversations in oncology care, offering trust, continuity, and expertise. Despite some concerns regarding responsibility and medical decision-making, their role can improve the quality of ACP, supporting more personalized and timely palliative care.

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病例管理人员在肿瘤护理中被定位为关键的提前护理计划对话者：一项关于医疗保健专业人员和患者观点的定性访谈研究

全球癌症负担的增加和治疗方法的进步延长了患者的预期寿命，导致更大的预后不确定性和对姑息治疗的更高需求。在这种情况下，预先护理计划（ACP）至关重要，它确保患者未来的护理符合他们的价值观和偏好。肿瘤学病例管理人员，作为受过专门培训的护士，已经成为ACP的关键谈话者。本研究探讨了医疗保健专业人员和患者对病例管理人员作为晚期癌症患者ACP谈话者的看法。方法对荷兰一所大学医学中心的12名患者进行定性访谈研究，这些患者最近与他们的病例管理人员和12名医疗保健专业人员（包括医学肿瘤学家和病例管理人员）进行了ACP对话。采用归纳主题分析法对半结构化访谈笔录进行分析。结果：(1)信任是有效ACP的基础，患者重视病例管理员的熟悉度和可及性；(2) ACP与casemanager的能力和任务一致，因为他们的沟通技巧和疾病知识被视为优势；(3)与治疗决策责任相关的挑战，以及医学肿瘤学家不愿放弃对谈话的控制。患者和专业人士都认识到病例管理人员进行ACP对话的重要性。病例管理人员能够很好地引导肿瘤护理ACP对话，提供信任、连续性和专业知识。尽管在责任和医疗决策方面存在一些担忧，但他们的作用可以提高ACP的质量，支持更个性化和及时的姑息治疗。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.