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- Carole A Robinson, Gillian Fyles, and Michael McKenzie.
- School of Nursing, University of British Columbia, ART 132, 1147 Research Road, Kelowna, BC, V1V 1V7, Canada. carole.robinson@ubc.ca.
- J Cancer Educ. 2017 Jun 1; 32 (2): 301-307.
AbstractDespite evidence that Goals of Care (GOC) discussions should occur early in the disease trajectory, the majority occur close to end of life. In a pilot, oncologists routinely initiated GOC discussions with all patients in their everyday ambulatory practice. Following the pilot, 9 of 12 eligible oncologists participated in semi-structured interviews about their experiences. Analysis resulted in the identification of seven principles of good GOC discussions embedded in the oncologists' interviews, four barriers to engaging in GOC discussions and foundational education needs. Participants believed that the appropriate trigger for a GOC discussion is a diagnosis of advanced cancer, not simply a diagnosis of cancer, and supported the importance of selective and strategic targeting of GOC discussions. The findings have informed the development of an education-based model for culture change within a province-wide cancer care system.
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