{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:26:18Z","timestamp":1777929978543,"version":"3.51.4"},"reference-count":37,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Palliative Medicine Reports"],"published-print":{"date-parts":[[2025,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Goals of care (GOC) discussions align medical care with patients\u2019 wishes. Many physician-associated barriers to GOC discussions have been identified, but there is little understanding of the lived experiences of patients and their nominated health care spokespersons (NHSs) who have participated in the discussion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>We aimed to describe the lived experience of participants of GOC discussions conducted during acute inpatient care and identify the features of well-conducted GOC discussions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a qualitative enquiry based on grounded theory, employing a social-constructivist approach and interpretivist research paradigm. Participants were purposively sampled from the medical oncology, geriatric, and palliative medicine departments of a tertiary hospital in Singapore. Data was gathered using semi-structured interviews.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 24 interviews (16 NHS, 8 patients) were conducted. All participants were patients or NHS of patients who lived with a life-limiting illness (15 Cancer, 9 Non-cancer). The analysis yielded 2 major themes\u2014\n                      <jats:italic toggle=\"yes\">Preconceived health perceptions<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">Desired communications skills<\/jats:italic>\n                      \u2014and 6 subthemes\u2014\n                      <jats:italic toggle=\"yes\">Elusive knowledge<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">Emotional undertones<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">Existential struggles<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">Explicit clarity<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">Embracing empathy,<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">Enhancing autonomy<\/jats:italic>\n                      . Well-conducted GOC discussions occurred when the participants\u2019 health perceptions were satisfied by a complementary communication skill employed by the physician, based on the model \u201cCommunicating to the\n                      <jats:italic toggle=\"yes\">Intellect<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">Heart,<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">Person<\/jats:italic>\n                      .\u201d\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      Well-conducted GOC discussions that facilitated consensus were discussions where the physician engaged the participant at three levels\u2014the\n                      <jats:italic toggle=\"yes\">Intellect, Heart,<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">Person<\/jats:italic>\n                      . Our model advocates for person-centered conversations where the views of the participant are heard and will provide insights to improve the conduct of GOC discussions.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/pmr.2025.0020","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T03:22:36Z","timestamp":1750044156000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Communicating to the Intellect, Heart, and Person: A Model Describing Participants\u2019 Experience of Goals of Care Discussions Conducted During Acute Inpatient Care"],"prefix":"10.1177","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0879-6845","authenticated-orcid":false,"given":"Joshua S.","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Continuing and Community Care, Tan Tock Seng Hospital, Singapore, Singapore."},{"name":"Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore, Singapore."},{"name":"Institute of Geriatrics and Active Aging, Singapore, Singapore."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katrielle Joy X.Y.","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, Woodlands Health Campus, Singapore, Singapore."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lynn","family":"Wiryasaputra","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, Tan Tock Seng Hospital, Singapore, Singapore."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Celestine Z.Q.","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore, Singapore."},{"name":"Institute of Geriatrics and Active Aging, Singapore, Singapore."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul Victor","family":"Patinadan","sequence":"additional","affiliation":[{"name":"Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph Y.J.","family":"Ong","sequence":"additional","affiliation":[{"name":"Dover Park Hospice, Singapore, Singapore."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andy H.Y.","family":"Ho","sequence":"additional","affiliation":[{"name":"Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore."},{"name":"Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tricia S.H.","family":"Yung","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, Tan Tock Seng Hospital, Singapore, Singapore."},{"name":"Dover Park Hospice, Singapore, Singapore."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,6,16]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.5271"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2018.10.507"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2019.07.024"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-156-3-201202070-00008"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.18913"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-009032"},{"key":"e_1_3_6_8_2","unstructured":"Choices R. 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