{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T23:20:57Z","timestamp":1791588057334,"version":"4.3.4"},"reference-count":39,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T00:00:00Z","timestamp":1727395200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006209","name":"radboud universitair medisch centrum","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006209","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010763","name":"zorginstituut nederland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010763","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Palliat Med"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Implementing shared decision-making in oncology practice is often limited, particularly integrating the patient\u2019s context into decision-making. To improve this, we conducted a quality improvement project, CONtext. CONtext attempts to accomplish this by: (1) Integrating the patient\u2019s context into shared decision-making during consultation with the medical oncologist; (2) Actively involving the GP and case manager (a specialized oncology nurse), who often have knowledge about the patient\u2019s context, and; (3) Giving the person with advanced cancer a time-out period of up to 2\u2009weeks to consider and discuss treatment options with others, including close family and friends.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To explore how persons with advanced cancer and their involved professionals experienced shared decision-making after the introduction of CONtext.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A qualitative embedded multiple-case study using in-depth interviews analysed with inductive content analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants:<\/jats:title>\n                    <jats:p>A purposive sample of 14 cases, each case consisting of a patient with advanced cancer and ideally their medical oncologist, case manager, and GP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Four themes were identified: shared decision-making is a dynamic and continuous process (1), in which the medical oncologist\u2019s treatment recommendation is central (2), fuelled by the patients\u2019 experience of not having a choice (3), and integrating the patient\u2019s context into shared decision-making was considered important but hampered (4), for example, by the association with the terminal phase.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The prevailing tendency among medical oncologists and persons with advanced cancer to prioritize life-prolonging anticancer treatments restricts the potential for shared decision-making. This undermines integrating individual context into decision-making, a critical aspect of the palliative care continuum.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02692163241281145","type":"journal-article","created":{"date-parts":[[2024,9,28]],"date-time":"2024-09-28T02:00:04Z","timestamp":1727488804000},"page":"1156-1168","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["The focus on life-prolonging anticancer treatment hampers shared decision-making in people with advanced cancer: A qualitative embedded multiple-case study"],"prefix":"10.1177","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1985-2839","authenticated-orcid":false,"given":"Daisy JM","family":"Ermers","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, Pain, and Palliative Medicine, Radboud Institute for Health Sciences, Radboudumc, Nijmegen, The Netherlands"},{"name":"Department of Primary and Community Care, Radboudumc, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maartje J","family":"van Geel","sequence":"additional","affiliation":[{"name":"Consultancy Group Process Improvement and Implementation, Radboudumc, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7669-1018","authenticated-orcid":false,"given":"Yvonne","family":"Engels","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pain, and Palliative Medicine, Radboud Institute for Health Sciences, Radboudumc, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Demi","family":"Kellenaers","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pain, and Palliative Medicine, Radboud Institute for Health Sciences, Radboudumc, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anouk SJ","family":"Schuurmans","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pain, and Palliative Medicine, Radboud Institute for Health Sciences, Radboudumc, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floortje K","family":"Ploos van Amstel","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Radboudumc, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla ML","family":"van Herpen","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Radboudumc, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"Schoon","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Radboudumc, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henk J","family":"Schers","sequence":"additional","affiliation":[{"name":"Department of Primary and Community Care, Radboudumc, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kris CP","family":"Vissers","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pain, and Palliative Medicine, Radboud Institute for Health Sciences, Radboudumc, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelien JM","family":"Kuip","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pain, and Palliative Medicine, Radboud Institute for Health Sciences, Radboudumc, Nijmegen, The Netherlands"},{"name":"Department of Medical Oncology, Radboudumc, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marieke","family":"Perry","sequence":"additional","affiliation":[{"name":"Department of Primary and Community Care, Radboudumc, Nijmegen, The 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