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Advance Care Planning: Promoting Effective and Aligned Communication in the Elderly
The purpose of this study is to reduce the burden of cancer and its consequences for an aging US cancer population. To accomplish this, we propose to plan and conduct a pragmatic stepped wedge cluster randomized trial (SW-CRT) of a Comprehensive ACP (Advance Care Planning) Program among older oncology patients.
The ACP Program will include training clinicians in communication skills and using video decision aids for patients. We will recruit patients from organ-based oncology clinics served by three major health care systems: Duke Health (North Carolina), the Mayo Clinic (Minnesota), and Northwell Health (New York).
Assessing the Patient Experience in Cancer Care: An Observational Communication Study
Communication is an important component of comprehensive cancer care impacting patient satisfaction, adherence, and quality of life. The wide array of issues addressed in cancer clinical interactions makes communicating about a broad range of topics (including quality of life, communication, symptom control, complementary/alternative therapies, costs, treatment burden, prognosis, anxiety, side-effects, sexual function, palliative care options, etc.) especially interesting and potentially challenging. Some of these topics may not be routinely addressed in the clinical interaction or may require consultative support from other members of the comprehensive cancer care team. One frequently overlooked critical element in research on communication between cancer clinicians, their patients, and their primary care clinicians is describing real-time consultations between patients and their clinicians. These interactions provide rich material for assessing key psycho-social dynamics and identifying issues that patients find important in their care. In order to devise systems of care that optimize the patient experience, it is critical that clinicians and researchers understand, appreciate, and systematically characterize the richness and complexity of the decision-making process in routine cancer consultations between cancer patients and their treating clinicians. This study seeks to assess the patient experience in cancer care by observing patients and their physicians in their clinical interactions and following them for several months to see how their care went. By describing in-depth the conversations and experiences of patients in these clinical interactions, this study will lay the foundation for practice-based interventions to optimize patients' interactions with their cancer care teams.
Pilot Testing of a Prostate Cancer Knowledge Questionnaire
The purpose of this study is to clinically test the use of a questionnaire to determine how well it detects differences in knowledge about prostate cancer among newly diagnosed individuals with the disease.