A model of treatment decision making when patients have advanced cancer: how do cancer treatment doctors and nurses contribute to the process?
Corresponding Author
L. MCCULLOUGH msc, nurse leader clinical support services
Wellington Hospital, Capital and Coast District Health Board, Wellington South, Wellington
Leslie McCullough, Wellington Hospital, Capital and Coast District Health Board, Private Bag 7902, Wellington South, Wellington 6242, New Zealand (e-mail: [email protected]). Search for more papers by this authorE. MCKINLAY ma (app), senior lecturer
School of Medicine and Health Sciences, Otago University, Wellington
Search for more papers by this authorC. BARTHOW ma (app), formerly teaching associate
Graduate School of Nursing, Midwifery and Health, Victoria University of Wellington, Wellington
Search for more papers by this authorC. MOSS phd, formerly associate professor
Graduate School of Nursing, Midwifery and Health, Victoria University of Wellington, Wellington
Search for more papers by this authorD. WISE mpc, palliative care nurse specialist
C/-Community Health, Hutt Valley DHB, Lower Hutt, New Zealand
Search for more papers by this authorCorresponding Author
L. MCCULLOUGH msc, nurse leader clinical support services
Wellington Hospital, Capital and Coast District Health Board, Wellington South, Wellington
Leslie McCullough, Wellington Hospital, Capital and Coast District Health Board, Private Bag 7902, Wellington South, Wellington 6242, New Zealand (e-mail: [email protected]). Search for more papers by this authorE. MCKINLAY ma (app), senior lecturer
School of Medicine and Health Sciences, Otago University, Wellington
Search for more papers by this authorC. BARTHOW ma (app), formerly teaching associate
Graduate School of Nursing, Midwifery and Health, Victoria University of Wellington, Wellington
Search for more papers by this authorC. MOSS phd, formerly associate professor
Graduate School of Nursing, Midwifery and Health, Victoria University of Wellington, Wellington
Search for more papers by this authorD. WISE mpc, palliative care nurse specialist
C/-Community Health, Hutt Valley DHB, Lower Hutt, New Zealand
Search for more papers by this authorAbstract
MCCULLOUGH L., MCKINLAY E., BARTHOW C., MOSS C. & WISE D. (2010) European Journal of Cancer CareA model of treatment decision making when patients have advanced cancer: how do cancer treatment doctors and nurses contribute to the process?
This qualitative study describes how doctors and nurses report their contribution to treatment decision-making processes when patients have advanced cancer. Thirteen nurses and eight doctors involved in cancer treatment and palliation in one geographical location in New Zealand participated in the study. Data were collected using qualitative in-depth, face-to-face interviews. Content analysis revealed a complex context of decision making influenced by doctors and nurses as well as the patient and other factors. A model of clinician and patient decision making emerged with a distinct and cyclical process as advanced cancer remits and progresses. When patients have advanced cancer, nurses and doctors describe a predictable model of decision making in which they both contribute and that cycles through short- and long-term remissions; often nowadays to the point of the patient dying. In conclusion, the findings suggest doctors and nurses have different but complementary roles in what, when and how treatment choices are negotiated with patients, nevertheless within a distinct model of decision making.
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