Development of a guidance tool for a clinical intervention trial in oncology
The duty to inform the patient that she is not recovering from advanced cancer and has only limited time left to live is a difficult but unavoidable task for the treating physician/oncologist causing a significant level of distress for physicians, patients and family members. However, not informing the patient of terminal status often results in futile treatment, overly burdening the patient and making unnecessary costs and use of health facilities. At that time it is clinically appropriate to make the transition to a palliative care approach. Communicating this transition to patients and their relatives requires specific communication skills and strategies. The underlying assumption is that effective communication between patient and physician about terminal status can actually lead to improved processes (quality of care) and outcomes (quality of life). Therefore we aim to develop a practice tool, validated by research, for oncology specialists to initiate and conduct conversations of terminal status.