Nurses Should Focus on Goal Setting and Shared Decision Making in Cancer Aftercare Conversations
Goal setting and shared decision making are important components of aftercare for cancer survivors. In the results of a study published in conjunction with the 2018 American Society of Clinical Oncology Annual Meeting, researchers shared their experience developing and pretesting a systematic conversation approach for nurses to tailor the aftercare needs and goals of cancer survivors.
The study was developed in four steps:
- Identifying problems
- Identifying overall objectives
- Designing the intervention
- Pretesting and adapting the intervention
According to the researchers, the study findings revealed problems such as nonsystematic and incomplete screening of potential issues, caveats in providing information, and involving patients in decision-making. Researchers also approached the study in phases, including preparation of the consultation (including a questionnaire), shared goal setting through a tool to visualize domains of life, shared care planning by means of an overview of possible choices in aftercare, a database listing the cancer care team and a cancer survivorship care plan, and an evaluation.
Researchers said the conversation approach in cancer aftercare helped keep the discussion patient centric and led to a more in-depth conversation between nurses and patients. The pretest in the study showed that nurses need to have a flexible approach to the conversation with patients so it can be tailored to patients’ individual needs and practice setting.
The study findings showed that finding the time to have the conversations is a challenge. Digitizing some parts of the conversation approach may help remove that barrier, the researchers noted.
The model was co-created with important aftercare stakeholders, incorporates evidence-based cancer care guidelines, and supports patient-centered care. “The results of the pretest revealed important implications and suggestions for implementation, such as tailoring and embedding the approach within care processes,” they added.