Evidence map›Paper›PMID 31278462›Full record

ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2020

Content analysis of Advance Directives completed by patients with advanced cancer as part of an Advance Care Planning intervention: insights gained from the ACTION trial.

Marieke Zwakman, J J M van Delden, G Caswell, L Deliens, F Ingravallo, L J Jabbarian, A T Johnsen, I J Korfage, A Mimić, C Møller Arnfeldt and 3 more

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

Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
2.9field-weighted citation impact, top 10% 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

8 citing papers in PubMed, 20 citations in OpenAlex.

  1. Primary Palliative Care Improves Uptake of Advance Care Planning Among Patients With Advanced Cancers.Journal of the National Comprehensive Cancer Network : JNCCN · 2023
    Trial
  2. Trial
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  4. Advanced cancer patients' knowledge and opinions regarding the French law on advance directives: a multicenter cross-sectional study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Article
  5. Review
  6. 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

13 authors at 9 institutions in 6 countries.

Marieke ZwakmanJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Stratenum 6.131, PO Box 85500, 3508, GA, Utrecht, The Netherlands. J.J.M.vanDelden@umcutrecht.nl.ORCID http://orcid.org/0000-0003-2934-8740
J J M van DeldenJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Stratenum 6.131, PO Box 85500, 3508, GA, Utrecht, The Netherlands.
G CaswellFaculty of Medicine and Health Sciences, School of Health Sciences, University of Nottingham, Nottingham, UK.
L DeliensEnd-of-life Care Research Group, Vrije Universiteit Brussel, Brussels, Belgium.
F IngravalloDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
L J JabbarianDepartment of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
A T JohnsenDepartment of Palliative Medicine, Bispebjerg and Frederiksberg Hospital, Research Unit, Copenhagen, Denmark.
I J KorfageDepartment of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
A MimićUniversity Clinic for Respiratory and Allergic Diseases Golnik, Golnik, Slovenia.
C Møller ArnfeldtDepartment of Palliative Medicine, Bispebjerg and Frederiksberg Hospital, Research Unit, Copenhagen, Denmark.
N J PrestonInternational Observatory on the End-of-Life Care, Lancaster University, Lancaster, LA1 4YG, UK.
M C KarsJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Stratenum 6.131, PO Box 85500, 3508, GA, Utrecht, The Netherlands.
ACTION consortium
University Medical Center Utrecht · NLErasmus MC · NLLancaster University · GBUniversity Clinic of Pulmonary and Allergic Diseases Golnik · SIUniversity of Bologna · ITUniversity of Copenhagen · DKUniversity of Nottingham · GBUniversity of Southern Denmark · DKVrije Universiteit Brussel · BE

Funding

FP7. Framework programme for research and Technological development Proposal No: 602541-2
6 · The paper itself

Abstract

purposeWriting an Advance Directive (AD) is often seen as a part of Advance Care Planning (ACP). ADs may include specific preferences regarding future care and treatment and information that provides a context for healthcare professionals and relatives in case they have to make decisions for the patient. The aim of this study was to get insight into the content of ADs as completed by patients with advanced cancer who participated in ACP conversations.

methodsA mixed methods study involving content analysis and descriptive statistics was used to describe the content of completed My Preferences forms, an AD used in the intervention arm of the ACTION trial, testing the effectiveness of the ACTION Respecting Choices ACP intervention.

resultsIn total, 33% of 442 patients who received the ACTION RC ACP intervention completed a My Preferences form. Document completion varied per country: 10.4% (United Kingdom), 20.6% (Denmark), 29.2% (Belgium), 41.7% (the Netherlands), 61.3% (Italy) and 63.9% (Slovenia). Content analysis showed that 'maintaining normal life' and 'experiencing meaningful relationships' were important for patients to live well. Fears and worries mainly concerned disease progression, pain or becoming dependent. Patients hoped for prolongation of life and to be looked after by healthcare professionals. Most patients preferred to be resuscitated and 44% of the patients expressed maximizing comfort as their goal of future care. Most patients preferred 'home' as final place of care.

conclusionsMy Preferences forms provide some insights into patients' perspectives and preferences. However, understanding the reasoning behind preferences requires conversations with patients.

Indexed as

Advance Care PlanningAdvance DirectivesDecision MakingAdultAgedAged, 80 and overBelgiumCommunicationDenmarkFemaleHealth PersonnelHumansItalyMaleMiddle AgedNeoplasmsAdvance Care PlanningAdvance DirectiveCancerContent analysisEnd of life

Identifiers

PMID31278462
PMCPMC6989617
OpenAlexW2954193934

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.