A patient's perspective on care decisions: a qualitative interview study

Area of Science:

• Medical Consultation
• Patient Preferences
• Advance Care Planning

Background:

• Discussing treatment wishes and limitations is crucial for patients to define future care goals.
• Barriers often lead patients and physicians to postpone or avoid these important conversations.

Purpose of the Study:

• To explore patient perceptions regarding discussing treatment wishes and limitations in an internal medicine outpatient clinic.

Main Methods:

• Conducted semi-structured interviews with 44 patients at a tertiary care teaching medical center.
• Employed a phenomenological approach with inductive, data-driven coding for thematic analysis.

Main Results:

• Patients associate treatment wishes with end-of-life, deeming them currently irrelevant.
• Patients perceive wishes as fixed, though they are often situation-dependent.
• Patients weigh the value of treatments ('is it worth it?'), assigning a key role to physicians.

Conclusions:

• Identified themes offer starting points for future interventions on advance care planning.
• Emphasized that care decisions are a continuous, dynamic process, relevant at all times.
• Highlighted the physician's critical role in facilitating these discussions.