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dc.creatorde Kort, Susanne Jen
dc.creatorPols, Jeannetteen
dc.creatorRichel, Dick Jen
dc.creatorKoedoot, Nellekeen
dc.creatorWillems, Dick Len
dc.date.accessioned2016-01-09T00:41:16Zen
dc.date.available2016-01-09T00:41:16Zen
dc.date.created2010-06en
dc.date.issued2010-06en
dc.identifierdoi:10.1007/s10728-009-0121-4en
dc.identifier.bibliographicCitationHealth care analysis : HCA : journal of health philosophy and policy 2010 Jun; 18(2): 164-74en
dc.identifier.urihttp://worldcatlibraries.org/registry/gateway?version=1.0&url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&atitle=Understanding+palliative+cancer+chemotherapy:+about+shared+decisions+and+shared+trajectories.&title=Health+care+analysis+:+HCA+:+journal+of+health+philosophy+and+policy+&volume=18&issue=2&date=2010-06&au=de+Kort,+Susanne+J;+Pols,+Jeannette;+Richel,+Dick+J;+Koedoot,+Nelleke;+Willems,+Dick+Len
dc.identifier.urihttp://dx.doi.org/10.1007/s10728-009-0121-4en
dc.identifier.urihttp://hdl.handle.net/10822/1022638en
dc.description.abstractMost models of patient-physician communication take decision-making as a central concept. However, we found that often the treatment course of metastatic cancer patients is not easy to describe in straightforward terms used in decision-making models but is instead frequently more erratic. Our aim was to analyse these processes as trajectories. We used a longitudinal case study of 13 patients with metastatic colorectal and pancreatic cancer for whom palliative chemotherapy was a treatment option, and analysed 65 semi-structured interviews. We analysed three characteristics of the treatment course that contributed to the 'erraticness' of the course: (1) The treatment (with or without chemotherapy) contained many options; (2) these options were not stable entities to be decided upon, but changed identity over the course of treatment, and (3) contrary to the closure (option X means no option Y, Z, etc.) a decision implies, the treatment course was a continuous process in which options instead remained open. When the treatment course is characterised by these many and changeable options that do not result in closure, the shared decision-making model should take these into account. More attention needs to be paid to the erratic character of the process in which the doctor has to provide continuous information that is related to the changing situation of the patient; also, flexibility in dealing with protocols is warranted, as is vigilance about the overall direction of the process.en
dc.formatArticleen
dc.languageenen
dc.sourceeweb:332934en
dc.subjectCanceren
dc.subjectCommunicationen
dc.subjectInterviewsen
dc.subjectPatientsen
dc.subject.classificationPatient Relationshipsen
dc.subject.classificationCare of the Dying Patienten
dc.titleUnderstanding Palliative Cancer Chemotherapy: About Shared Decisions and Shared Trajectoriesen
dc.provenanceCitation prepared by the Library and Information Services group of the Kennedy Institute of Ethics, Georgetown University for the ETHXWeb database.en
dc.provenanceCitation migrated from OpenText LiveLink Discovery Server database named EWEB hosted by the Bioethics Research Library to the DSpace collection EthxWeb hosted by DigitalGeorgetown.en


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