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Patient Self-Defined Goals: Essentials of Person-Centered Care for Serious Illness
Schellinger SE, Anderson EW, Frazer MS, Cain CL.. The American journal of hospice & palliative care, 2017-03-23
Topic: Risk, prevention and care in population studies
This research, a descriptive qualitative analysis of self-defined serious illness goals, expands the knowledge of what goals are important beyond the physical-making existing disease-specific guidelines more holistic. Integration of goals of care discussions and documentation is standard for quality palliative care but not consistently executed into general and specialty practice. Over 14 months, lay health-care workers (care guides) provided monthly supportive visits for 160 patients with advanced heart failure, cancer, and dementia expected to die in 2 to 3 years. Care guides explored what was most important to patients and documented their self-defined goals on a medical record flow sheet. Using definitions of an expanded set of whole-person domains adapted from the National Consensus Project (NCP) Clinical Practice Guidelines for Quality Palliative Care, 999 goals and their associated plans were deductively coded and examined. Four themes were identified-medical, nonmedical, multiple, and global. Forty percent of goals were coded into the medical domain; 40% were coded to nonmedical domains-social (9%), ethical (7%), family (6%), financial/legal (5%), psychological (5%), housing (3%), legacy/bereavement (3%), spiritual (1%), and end-of-life care (1%). Sixteen percent of the goals were complex and reflected a mix of medical and nonmedical domains, "multiple" goals. The remaining goals (4%) were too global to attribute to an NCP domain. Self-defined serious illness goals express experiences beyond physical health and extend into all aspects of whole person. It is feasible to elicit and record serious illness goals. This approach to goals can support meaningful person-centered care, decision-making, and planning that accords with individual preferences of late life.
Key findings
- Sixteen percent of the goals were complex and reflected a mix of medical and nonmedical domains, "multiple" goals.
- The remaining goals (4%) were too global to attribute to an NCP domain.
- Self-defined serious illness goals express experiences beyond physical health and extend into all aspects of whole person.
- It is feasible to elicit and record serious illness goals.
- This approach to goals can support meaningful person-centered care, decision-making, and planning that accords with individual preferences of late life.
Study details
- Participants160
- Evidence strengthLow
How this study scored 50/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 29 of the 58 points we could judge it on, which is 50 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The American journal of hospice & palliative care) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2018 — within 10 year(s) of the newest study here |
| Sample size | 2 / 4 | 160 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 28330379) |
| Free to read | 2 / 2 | Free to read |
| Points | 29 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 29 of the 58 points we could judge it on is 50 out of 100. |
| Total | 50 / 100 | — |
What each of these 20 components measures, and what this score is not →
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
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APA 7th
Schellinger, S. E., Anderson, E. W., Frazer, M. S., & Cain, C. L. (2018). Patient Self-Defined Goals: Essentials of Person-Centered Care for Serious Illness. The American journal of hospice & palliative care. https://doi.org/10.1177/1049909117699600
Vancouver
Schellinger SE, Anderson EW, Frazer MS, Cain CL. Patient Self-Defined Goals: Essentials of Person-Centered Care for Serious Illness. The American journal of hospice & palliative care. 2018. doi:10.1177/1049909117699600. PMID: 28330379.
BibTeX
@article{schellinger2018-28330379,
author = {Schellinger, S. E. and Anderson, E. W. and Frazer, M. S. and Cain, C. L.},
title = {{Patient Self-Defined Goals: Essentials of Person-Centered Care for Serious Illness}},
journal = {The American journal of hospice \& palliative care},
year = {2018},
doi = {10.1177/1049909117699600},
pmid = {28330379},
url = {https://doi.org/10.1177/1049909117699600}
}
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