Evidence map›Paper›PMID 30736754›Full record

ArticleBMC cancer2019

Breaking silence: a survey of barriers to goals of care discussions from the perspective of oncology practitioners.

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

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC cancer, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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

24 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  19. Barriers and facilitators for shared decision-making in oncology inpatient practice: an explorative study of the healthcare providers' perspective.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022
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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

9 authors.

Katrina Lynn PiggottDepartment of Geriatric Medicine, 30 Bond Street, Room 4-002, Shuter Wing, Toronto, ON, M5B 1W8, Canada. katrina.piggott@mail.utoronto.ca.
Ameen PatelDepartment of Medicine, McMaster University, 1200 Main Street West, Hamilton, ON, L8N 3Z5, Canada.
Arthur WongDepartment of Medicine, McMaster University, 1200 Main Street West, Hamilton, ON, L8N 3Z5, Canada.
Leslie MartinDepartment of Medicine, McMaster University, 1200 Main Street West, Hamilton, ON, L8N 3Z5, Canada.
Alexandra PatelDepartment of Occupational Science and Occupational Therapy, The University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada.
Matthew PatelRoyal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin 2, Ireland.
Yudong LiuSchulich School of Dentistry, University of Western Ontario, 1151 Richmond St, London, ON, N6A 5C1, Canada.
Sukhbinder Dhesy-ThindDepartment of Oncology, McMaster University, 699 Concession St, Hamilton, ON, L8V 5C2, Canada.
John J YouDepartment of Medicine, McMaster University, 1200 Main Street West, Hamilton, ON, L8N 3Z5, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCancer is the leading cause of death in the developed world, and yet healthcare practitioners infrequently discuss goals of care (GoC) with hospitalized cancer patients. We sought to identify barriers to GoC discussions from the perspectives of staff oncologists, oncology residents, and oncology nurses.

methodsThis was a single center survey of staff oncologists, oncology residents, and inpatient oncology nurses. Barriers to GoC discussions were assessed on a 7-point Likert scale (1 = extremely unimportant; 7 = extremely important).

resultsBetween July 2013 and May 2014, of 185 eligible oncology clinicians, 30 staff oncologists, 10 oncology residents, and 28 oncology nurses returned surveys (response rate of 37%). The most important barriers to GoC discussions were patient and family factors. They included family members' difficulty accepting poor prognoses (mean score 5.9, 95% CI [5.7, 6.2]), lack of family agreement in the goals of care (mean score 5.8, 95% CI [5.5, 6.1]), difficulty understanding the limitations of life-sustaining treatments (mean score 5.8, 95% CI [5.6, 6.1]), lack of patients' capacity to make goals of care decisions (mean score 5.7, 95% CI [5.5, 6.0]), and language barriers (mean score 5.7, 95% CI [5.4, 5.9]). Participants viewed system factors and healthcare provider factors as less important barriers.

conclusionsOncology practitioners perceive patient and family factors as the most limiting barriers to GoC discussions. Our findings underscore the need for oncology clinicians to be equipped with strong communication skills to help patients and families navigate GoC discussions.

Indexed as

Medical OncologyOncologistsAdultAttitude of Health PersonnelCommunicationCross-Sectional StudiesDecision MakingFemaleHealth Care SurveysHumansMaleMiddle AgedPatient Care PlanningSurveys and QuestionnairesBarriersCancer careEnd of lifeGoals of care discussions

Identifiers

PMID30736754
PMCPMC6368724

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.