Evidence map›Paper›PMID 29934292›Full record

ArticleCMAJ open

Role of allied health care professionals in goals-of-care discussions with hospitalized patients and perceived barriers: a cross-sectional survey.

Leslie Martin, Ameen Patel, Katrina Piggott, Arthur Wong, Alexandra Patel, Matthew Patel, Yudong Liu, Sukhbinder Dhesy-Thind, Parveen Wasi, John J You

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.2field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 2 countries.

Leslie MartinDepartment of Medicine (Martin, Ameen Patel, Wong, Wasi, You), McMaster University, Hamilton, Ont.; Department of Geriatric Medicine (Piggott), University of Toronto; Victoria College (Alexandra Patel), University of Toronto, Toronto, Ont.; Royal College of Surgeons in Ireland (M. Patel), Dublin, Ireland; Schulich School of Dentistry & Medicine (Liu), Western University, London, Ont.; Departments of Oncology (Dhesy-Thind) and Health Research Methods, Evidence, and Impact (You), McMaster University, Hamilton, Ont. leslie.martin@medportal.ca.
Ameen PatelDepartment of Medicine (Martin, Ameen Patel, Wong, Wasi, You), McMaster University, Hamilton, Ont.; Department of Geriatric Medicine (Piggott), University of Toronto; Victoria College (Alexandra Patel), University of Toronto, Toronto, Ont.; Royal College of Surgeons in Ireland (M. Patel), Dublin, Ireland; Schulich School of Dentistry & Medicine (Liu), Western University, London, Ont.; Departments of Oncology (Dhesy-Thind) and Health Research Methods, Evidence, and Impact (You), McMaster University, Hamilton, Ont.
Katrina PiggottDepartment of Medicine (Martin, Ameen Patel, Wong, Wasi, You), McMaster University, Hamilton, Ont.; Department of Geriatric Medicine (Piggott), University of Toronto; Victoria College (Alexandra Patel), University of Toronto, Toronto, Ont.; Royal College of Surgeons in Ireland (M. Patel), Dublin, Ireland; Schulich School of Dentistry & Medicine (Liu), Western University, London, Ont.; Departments of Oncology (Dhesy-Thind) and Health Research Methods, Evidence, and Impact (You), McMaster University, Hamilton, Ont.
Arthur WongDepartment of Medicine (Martin, Ameen Patel, Wong, Wasi, You), McMaster University, Hamilton, Ont.; Department of Geriatric Medicine (Piggott), University of Toronto; Victoria College (Alexandra Patel), University of Toronto, Toronto, Ont.; Royal College of Surgeons in Ireland (M. Patel), Dublin, Ireland; Schulich School of Dentistry & Medicine (Liu), Western University, London, Ont.; Departments of Oncology (Dhesy-Thind) and Health Research Methods, Evidence, and Impact (You), McMaster University, Hamilton, Ont.
Alexandra PatelDepartment of Medicine (Martin, Ameen Patel, Wong, Wasi, You), McMaster University, Hamilton, Ont.; Department of Geriatric Medicine (Piggott), University of Toronto; Victoria College (Alexandra Patel), University of Toronto, Toronto, Ont.; Royal College of Surgeons in Ireland (M. Patel), Dublin, Ireland; Schulich School of Dentistry & Medicine (Liu), Western University, London, Ont.; Departments of Oncology (Dhesy-Thind) and Health Research Methods, Evidence, and Impact (You), McMaster University, Hamilton, Ont.
Matthew PatelDepartment of Medicine (Martin, Ameen Patel, Wong, Wasi, You), McMaster University, Hamilton, Ont.; Department of Geriatric Medicine (Piggott), University of Toronto; Victoria College (Alexandra Patel), University of Toronto, Toronto, Ont.; Royal College of Surgeons in Ireland (M. Patel), Dublin, Ireland; Schulich School of Dentistry & Medicine (Liu), Western University, London, Ont.; Departments of Oncology (Dhesy-Thind) and Health Research Methods, Evidence, and Impact (You), McMaster University, Hamilton, Ont.
Yudong LiuDepartment of Medicine (Martin, Ameen Patel, Wong, Wasi, You), McMaster University, Hamilton, Ont.; Department of Geriatric Medicine (Piggott), University of Toronto; Victoria College (Alexandra Patel), University of Toronto, Toronto, Ont.; Royal College of Surgeons in Ireland (M. Patel), Dublin, Ireland; Schulich School of Dentistry & Medicine (Liu), Western University, London, Ont.; Departments of Oncology (Dhesy-Thind) and Health Research Methods, Evidence, and Impact (You), McMaster University, Hamilton, Ont.
Sukhbinder Dhesy-ThindDepartment of Medicine (Martin, Ameen Patel, Wong, Wasi, You), McMaster University, Hamilton, Ont.; Department of Geriatric Medicine (Piggott), University of Toronto; Victoria College (Alexandra Patel), University of Toronto, Toronto, Ont.; Royal College of Surgeons in Ireland (M. Patel), Dublin, Ireland; Schulich School of Dentistry & Medicine (Liu), Western University, London, Ont.; Departments of Oncology (Dhesy-Thind) and Health Research Methods, Evidence, and Impact (You), McMaster University, Hamilton, Ont.
Parveen WasiDepartment of Medicine (Martin, Ameen Patel, Wong, Wasi, You), McMaster University, Hamilton, Ont.; Department of Geriatric Medicine (Piggott), University of Toronto; Victoria College (Alexandra Patel), University of Toronto, Toronto, Ont.; Royal College of Surgeons in Ireland (M. Patel), Dublin, Ireland; Schulich School of Dentistry & Medicine (Liu), Western University, London, Ont.; Departments of Oncology (Dhesy-Thind) and Health Research Methods, Evidence, and Impact (You), McMaster University, Hamilton, Ont.
John J YouDepartment of Medicine (Martin, Ameen Patel, Wong, Wasi, You), McMaster University, Hamilton, Ont.; Department of Geriatric Medicine (Piggott), University of Toronto; Victoria College (Alexandra Patel), University of Toronto, Toronto, Ont.; Royal College of Surgeons in Ireland (M. Patel), Dublin, Ireland; Schulich School of Dentistry & Medicine (Liu), Western University, London, Ont.; Departments of Oncology (Dhesy-Thind) and Health Research Methods, Evidence, and Impact (You), McMaster University, Hamilton, Ont.
University of Toronto · CARoyal College of Surgeons in Ireland · IE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAllied health care professionals can contribute meaningfully to goals-of-care discussions with seriously ill hospitalized patients and their families. We sought to explore the perspective of hospital-based allied health care professionals on their role in goals-of-care discussions and to identify barriers to their participation.

methodsWe surveyed allied health care professionals (social workers, physiotherapists, occupational therapists, registered dietitians, speech-language pathologists and pharmacists) on internal medicine, hematology-oncology, medical oncology and radiation oncology wards at 2 tertiary care hospitals in Hamilton, Ontario, from April 2013 to May 2014. We modified a validated questionnaire originally designed to assess barriers to discussing goals of care from the perspective of nurses, residents and staff physicians on hospital medical wards. Respondents rated the questionnaire items on a 7-point Likert scale.

resultsOf the 47 allied health care professionals invited, 32 (68%) participated: 9 physiotherapists, 7 social workers, 6 occupational therapists, 4 registered dietitians, 3 pharmacists and 2 speech-language pathologists; in 1 case, the profession was unknown. The greatest perceived barriers to engaging in goals-of-care discussions were lack of patient decision-making capacity (mean rating 5.9 [standard error (SE) 0.3]), lack of awareness of patients' previous discussions with other team members (mean rating 5.7 [SE 0.3]) and family members' difficulty accepting a poor prognosis (mean rating 5.6 [SE 0.2]). Although the respondents felt it was most acceptable for staff physicians, residents and advanced practice nurses to exchange information and reach a final decision during goals-of-care discussions, they felt it was acceptable for a broader range of allied health care professionals to initiate discussions (mean rating 4.7-5.8) and to act as decision coaches (clarifying values, weighing options) with patients and families (mean rating 5.3-6.1).

interpretationAllied health care professionals are willing to initiate goals-of-care discussions and to act as a decision coach with seriously ill hospitalized patients and their families. By improving interprofessional collaboration, we can engage the entire health care team in this process.

Identifiers

PMID29934292
PMCPMC7868088
OpenAlexW2809505224

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.