INTRODUCTION The ability of oncologists to understand patients' goals of care is recognized as a key component of quality care. The purpose of this study is to examine the influence of patient-oncologist agreement regarding goals of care upon aggressive care at end of life (EOL) for patients with advanced cancer. METHODS Patients with advanced cancer and their oncologists were interviewed at study enrollment and every 3 months thereafter until patient death or end of the study period (15 months). A 100-point visual analogue scale was used to represent goals of care, with quality of life (scored as 0) and survival (scored as 100) as anchors. Strong goal of care agreement for survival was defined as oncologist and patient dyadic goal of care scores that fell between 70 and 100 (100 = highest goal for survival) and for comfort, dyadic goal of care values that fell between 0 and 30 (0 = high goal for comfort). RESULTS Two hundred and six patients and eleven oncologists provided data. At the last interview prior to death, 23.3% of dyads had strong goal of care agreement for either survival (8.3%) or comfort (15%) and 76.7% had no strong agreement. There was a significant association between aggressive care use and categories of dyadic agreement regarding goals of care (p = 0.024, Cramer's V = 0.15). CONCLUSIONS A large percentage of oncologists did not understand their patients' EOL goals of care. While aggressive care aligned with categories of dyadic agreement for goals of care, high rates of aggressive care were reported.

中文翻译：

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患者与肿瘤科医生在晚期癌症患者临终护理目标和积极护理方面达成的强烈共识之间存在关联。


简介 肿瘤科医生了解患者护理目标的能力被认为是优质护理的关键组成部分。本研究的目的是检验患者与肿瘤科医生在护理目标方面达成的共识对晚期癌症患者临终 (EOL) 积极护理的影响。方法 在研究入组时以及此后每 3 个月对晚期癌症患者及其肿瘤科医生进行访谈，直至患者死亡或研究期（15 个月）结束。使用 100 分视觉模拟量表来代表护理目标，以生活质量（评分为 0）和生存（评分为 100）作为锚点。生存的强护理目标协议被定义为肿瘤科医生和患者的二元护理目标分数落在 70 到 100 之间（100 = 最高生存目标），而舒适度的二元护理目标值落在 0 到 30 之间（0 =舒适度的高目标）。结果 206 名患者和 11 名肿瘤科医生提供了数据。在死亡前的最后一次访谈中，23.3% 的夫妻对生存 (8.3%) 或舒适 (15%) 的护理目标有强烈的一致，而 76.7% 则没有强烈的一致。积极护理的使用与护理目标的二元一致性类别之间存在显着关联（p = 0.024，Cramer's V = 0.15）。结论 很大一部分肿瘤科医生不了解患者的 EOL 护理目标。虽然积极护理与护理目标的二元协议类别一致，但据报道积极护理的比率很高。