La Planificación Compartida de la Atención en personas con enfermedad oncológica en un instituto monográfico de cáncer: estudio descriptivo retrospectivo

Abstract

Introduction: Advance care planning (ACP) encourages people to express wishes, preferences and concerns in order to facilitate a shared care process between patient, family and professionals. This is especially relevant in cancer context. Materials and methods: A cross-sectional study was carried out to analyze the ACP process practices of the professionals through the clinical records of the last 3 months of life of a sample of deceased patients in one month in a monographic cancer hospital. Sociodemographic variables, diagnosis, level of therapeutic intensity, cognitive status and ACP variables were defined: preferences, concerns, preference for place of care and place of death, choice of surrogate and advance directive document (ADC) existence. Results: N░=░54; 61.1░% men; median age: 64.5 years. Main cancer disease: respiratory (22.2░%); 79.6░% expressed themselves. The ACP variables were preferences 74,1░% (n░=░40); concerns 75,9░% (n░=░41); surrogate 7.4░% (n░=░4); place of care: 27.8░% (n░=░ 15); place of death: 16.7░% (n░=░ 9). None had an ADC Preferences and concerns records are mainly carried out by the palliative cares teams. The level of therapeutic intensity in the preferences / concerns record was 3A. Concerns were associated with self-expression of the patient (p░<░0.001). Conclusions: Registration of ACP dimensions are poor and occurs mainly in end-of-life context. Variables such as the representative figure or the ADCs are scarce. Early integration of ACP in clinical practice would facilitate decision-making with cancer patients and would help to define the care process according to their wishes and preferences.