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If so, efforts should be made to facilitate EOL discussions in a larger framework and to allow healthcare professionals to flexibly cope with individual matters. In this context, the present study proposes that the EOL discussion should be concentrated on the process, rather than on documentation itself, and that AD or POLST should be considered as both the vehicle and product of the discussion.

Accordingly, there is no doubt that EOL discussion is critical to ensure better quality of life for the last months and days of the patient. Thus, the importance of knowledge and communication skills is obvious and cannot be emphasized enough to facilitate EOL discussions. Education and training for each target group, such as oncologists or resident physicians, need to be developed in the two dimensions of knowledge and communication, and social marketing would also be required to improve the stakeholder engagement.

In conclusion, this study revealed various perspectives of oncologists and resident physicians about EOL discussion in terms of the definition of terminal stage, clinical experience of EOL discussion, and opinions for better EOL discussion. The study respondents considered that knowledge of the medical, legal, and ethical aspects and communicational preparation were essential to deal with awkward situations of EOL care discussion process.


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The present study suggests that efforts should be made to educate and train healthcare providers who are engaged in EOL discussion, considering that the LST Decision Act will soon be implemented. Conflict of interest relevant to this article was not reported. National Center for Biotechnology Information , U. Journal List Cancer Res Treat v. Cancer Res Treat. Published online Jul 3.

Author information Article notes Copyright and License information Disclaimer. Received Sep 13; Accepted Jun This article has been cited by other articles in PMC. Abstract Purpose The aims of this study were to explore how oncologists and resident physicians practice end-of-life EOL discussions and to solicit their opinions on EOL discussions as a means to improve the quality of EOL care.

Materials and Methods A survey questionnaire was developed to explore the experiences and opinions about EOL discussions among oncologists and residents. Results A total of oncologists and residents participated in this study. Conclusion This study explored various perspectives of oncologists and resident physicians for EOL discussion. Keywords: Advance care planning, Communication, Oncologists, Resident physician.

Introduction Cancer is the most prevalent cause of death in Korea, despite recent advances in anti-cancer therapy. Materials and Methods Oncologists and resident physicians who treated cancer patients during the study period were invited to participate in this survey. Results 1. Subject characteristics A total of participants agreed to participate in this study. Table 1. General characteristics of respondents. Open in a separate window. Experience in EOL discussion Approximately two-thirds of the oncologists Table 2. Experience in end-of-life discussion. Opinions for better EOL discussion process Discontinuation of chemotherapy and exacerbation of disease such as metastasis or recurrence of disease were suggested as the two most significant indications to begin EOL discussion by both oncologists and residents Table 3.

Table 3. Opinions for better end-of-life discussion. Table 4. Barriers and facilitators of end-of-life discussion. Discussion This study aimed to investigate the clinical practice of EOL discussions, especially for terminal cancer patients, and the professional opinions on how to ensure better EOL discussions and what the major barriers and facilitators were conceived to be.

Footnotes Conflict of interest relevant to this article was not reported. References 1. Department of Health and Human Services; Decision making in medicine and health care. Annu Rev Clin Psychol.

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Introduction: a matter of life and death. Advance care planning: communicating about matters of life and death. New York: Springer; Institution of Medicine. Dying in America: improving quality and honoring individual preferences near the end of life. Too soon to give up: re-examining the value of advance directives. Am J Bioeth. Association of experience with illness and end-of-life care with advance care planning in older adults. J Am Geriatr Soc. The understanding of terminal cancer and its relationship with attitudes toward end-of-life care issues.

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Cracking open death: death conversations in primary care

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J Hosp Palliat Nurs. The hastings center guidelines for decisions on life-sustaining treatment and care near the end of life: revised and expanded second edition. New York: Oxford University Press; Am Fam Physician. National Comprehensive Cancer Network. Validation of the prognosis in palliative care study predictor models in terminal cancer patients.

Advance Care Planning Communicating About Matters of Life and Death by Leah Rogne Ph D and Susana

Korean J Fam Med. Advance care planning for cancer patients in primary care: a feasibility study.

Ryan J, Harrison J. Barriers to advance care planning: a sociological perspective. Advance care planning: communication about matters of life and death. Meisel A. End-of-life care. In: Crowley M, editor. From birth to death and bench to clinic: the Hastings Center bioethics briefing book for journalists, policymakers, and campaigns. Institute of Medicine.

Support Center Support Center. External link. Please review our privacy policy. Definition of terminal state a. Timing to initiate discussion a. When chemotherapy is expected to be discontinued. Discuss with a. Discussion subjects b. Hospice palliative care transfer a. Level of satisfaction about EOL discussion. When chemotherapy discontinuation is expected. Discussion initiated by a. Ongoing discussion by a. Treatment options included in discussion b. Factors considered for LST decision making a.

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