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. 2022 May;13(4):432-439.
doi: 10.1016/j.jgo.2022.01.010. Epub 2022 Feb 3.

Care planning priorities of older patients with advanced bladder cancer

Sarah R Jordan  1 , Christopher L Geiger  2 , Stacy M Fischer  3 , Elizabeth R Kessler  4
Affiliations

Care planning priorities of older patients with advanced bladder cancer

Sarah R Jordan et al. J Geriatr Oncol. 2022 May.

Abstract

Objectives: Advanced bladder cancer (ABC) disproportionately affects older adults, and little is known about older patients' priorities for care planning in advanced cancer. Patient-centered communication remains crucial to shared decision-making between patients, families, and providers. Yet, older patients with cancer may not always know how to express their preferences, and oncologists do not always review patients' informational needs. This study aimed to understand preferences of older patients with ABC related to their communication with providers and navigation of care planning.

Materials and methods: This qualitative descriptive study involved in-depth interviews and focus groups with older patients with ABC and their care partners, which explored their priorities for care planning and communication with providers, decision-making processes, and valued traits in ABC care. Data were analyzed using thematic analysis.

Results: Ten participants attended focus groups or interviews. Seven patients were male and three care partners were female. The mean age was 74. Time since ABC diagnosis ranged from three to seventeen months. Four key themes illustrate participants' priorities in their ABC care as older adults: 1. The significance of key phrasing in communication from oncologists, 2. The need for clear expectation-setting about prognosis and treatment, 3. The role of others in patient care decisions, and 4. Valued traits in care communication.

Conclusion: Older patients with ABC and their care partners are active participants in their care. Oncologists should prioritize setting clear expectations for treatment, involving family in care planning, and communicating honestly about expected changes to quality of life and functional status.

Keywords: Advanced bladder cancer; Care planning; Geriatric oncology; Qualitative.

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Conflict of interest statement

Declaration of Competing Interest The Authors declare that there is no conflict of interest related to this current research.

Figures

Figure 1.
Figure 1.
A conceptual framework for patient-provider communication adapted to advanced bladder cancer
Figure 2
Figure 2
Recruitment & Enrollment Process
See this image and copyright information in PMC

Comment in

  • Geriatrics.
    Griebling TL. Griebling TL. J Urol. 2022 Dec;208(6):1326-1328. doi: 10.1097/JU.0000000000002986. Epub 2022 Oct 4. J Urol. 2022. PMID: 36194655 No abstract available.

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