Early Discussion Of Patients' Values By Oncology Nurses.

3Background: Optimal advance care planning allows patients to articulate their values as an affirmation of personhood and a touchstone for medical decision-making. Ideally, it occurs when patients are well enough to express themselves thoughtfully, with opportunities for iteration as the clinical situation unfolds. We piloted a novel program of systematic, oncology nurse-led values discussions with patients soon after diagnosis, testing feasibility, and acceptability in high-volume clinics in a dedicated cancer center. Methods: Within an institutional initiative integrating primary and specialist palliative care from diagnosis for all cancer patients regardless of stage or prognosis, specialists trained oncology nurses (90 minutes) to use specific questions (re living well, hopes, fears, sources of strength, abilities essential for acceptable quality of life) and an empathic communication framework to discuss health-related values with newly-diagnosed patients over two consecutive clinic visits. Nurses su...