Faculty, Staff and Student Publications

Publication Date

9-1-2024

Journal

Gynecologic Oncology

DOI

10.1016/j.ygyno.2024.06.014

PMID

38954989

PMCID

PMC11740732

PubMedCentral® Posted Date

1-17-2025

PubMedCentral® Full Text Version

Author MSS

Abstract

Background: Peritoneal carcinomatosis (PC) is common in patients with advanced gynecologic and gastrointestinal cancers. Frequently, patients with PC undergo palliative surgery or procedures to manage disease-related complications and side effects. However, there are limited data regarding patients' and family caregivers' decision-making processes about these procedures. Thus, we sought to describe the decision-making experiences of patients with PC who elect to pursue palliative surgical procedures and their family caregivers.

Methods: We conducted a secondary analysis of qualitative data collected during a pilot randomized controlled trial of BOLSTER, a nurse-led telehealth intervention for patients with PC and their caregivers after an acute hospitalization and palliative procedure. Participants in both study arms described their experiences in semi-structured interviews. We re-analyzed coded qualitative data with a focus on understanding decision-making experiences surrounding palliative surgery and procedures using conventional content analysis.

Results: Interviews from 32 participants, 23 patients and 9 caregivers, were analyzed. Participants reported their decision-making was complicated by illness uncertainty and a desire for clear, effective communication with surgical and medical oncology teams. Participants requested more information about the impact of palliative procedures on their daily life. Several also noted that, without improved understanding, a misalignment between patient and family caregiver goals and palliative procedures may inadvertently increase suffering.

Conclusion: Discussions related to patients' goals and preferences can improve the quality of treatment decision-making in patients with PC and their caregivers. Future research should test interventions to improve advanced cancer patients' illness understanding and decision-making surrounding palliative surgery and procedures.

Keywords

Humans, Female, Palliative Care, Peritoneal Neoplasms, Middle Aged, Aged, Decision Making, Caregivers, Adult, Pilot Projects, Genital Neoplasms, Female, Telemedicine, Qualitative Research

Published Open-Access

yes

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