This research study will examine how patients with advanced breast cancer and their oncology team communicate and plan ongoing care.The purpose of this study is to find out more about care planning during advanced breast cancer. The study will see if certain aspects of communication make a difference in how patients understand their illness.
The new communication practice (T-PAT) is a team approach for discussing prognosis and treatment goals. T-PAT is specifically designed to a) increase understanding of the prognosis and treatment goal, b) decrease illness uncertainty, and c) help the patient preserve hope for the future.This dedicated clinical visit features a structured discussion of prognosis, treatment goals and options, and end of life concerns. The planned team discussion will include information contributions for the treating medical oncologist, an oncology nurse and social worker who currently work together to provide breast cancer care. Primary Objectives: 1. Assess the feasibility of implementing the T-PAT prognosis discussion intervention. 2. Compare the effects of T-PAT vs. usual care on pertinent patient reported outcomes including: a) understanding of the prognosis and treatment goal, b) illness uncertainty, and c) hope. * First, a survey will be administered to patients in the waiting room before the next office visit. This should take 15-20 minutes. * The second part involves participating in a scheduled appointment that will be audio-recorded and focus on sharing information about the patient's illness. Patients will be randomized to either participate in an appointment featuring new communication practices (T-PAT)or a regular care appointment. * The third part involves a 20 minute survey, after the appointment, with a member of the study staff. This will take place over the telephone one or two days after the appointment. * The fourth part is completion of a written reflection on the patients participation in the study, which will be returned in a pre-addressed, stamped envelope. Generally, this should take about 15 minutes.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
29
Case Medical Center, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center
Cleveland, Ohio, United States
Feasibility of Implementing the T-PAT Prognosis Discussion Intervention
Accuracy and completion rate of the planned intervention components will be observed.
Time frame: 8 months
Patient Recorded Measures: Hope
Using the Snyder et al.'s State Hope Scale
Time frame: 8 months
Patient Recorded Measures: Willingness to Tolerate Adverse States
Six-Item scale that measures motivation to endure burden associated with aggressive care. Higher scores indicate a greater willingness to tolerate adverse states.
Time frame: 8 months
Patient Recorded Measures: Medical Outcomes Study-Physical Functioning Measure (MOS-PF)
Assess patient physical function
Time frame: 8 months
Patient Recorded Measures: Belief in Curability (BIC)
Assess patients perceptions about prognosis independent of what they recall being told by their doctor.
Time frame: 8 months
Patient Recorded Measures: Illness Uncertainty
16-item scale tapping patient uncertainty about symptoms, diagnosis, treatment, and future plans.
Time frame: 8 months
Patient Recorded Measures: Treatment Goal Preference
Patients will be asked to report their preference for aggressive care.
Time frame: 8 months
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