{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T19:44:51Z","timestamp":1770493491462,"version":"3.49.0"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T00:00:00Z","timestamp":1663804800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T00:00:00Z","timestamp":1663804800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Palliat Care"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Advance care planning (ACP) and goals of care discussions are important instruments that enable respect for patient autonomy, especially in patients with a life-threatening disease, such as cancer. Despite their well-established benefits, ACP and goals of care discussions are still not frequently performed in clinical oncology practice. Understanding the barriers to this topic is the first step toward developing future interventions that are more likely to improve professional practice and patient satisfaction with care.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Aim<\/jats:title>\n                <jats:p>To explore Brazilian oncologists\u2019 barriers to discuss goals of care and advance care planning.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A cross-sectional study was developed to identify Brazilian oncologists\u2019 barriers to discussing goals of care and ACP. The <jats:italic>Decide-Oncology<\/jats:italic> questionnaire was used to identify the importance of these barriers according to oncologists\u2019 perceptions. Participants were asked to rank the importance of various barriers to discussing goals of care, ranging from 1 (extremely unimportant) to 7 (extremely important). A quantitative analysis using descriptive statistics was used, including median and interquartile intervals and a qualitative analysis based on Bardin content analysis of the two open questions.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Sixty-six oncologists participated in this study. Most of them perceived the patient and family\u2019s related barriers as the most important, such as patients\u2019 difficulty in understanding their diagnosis and accepting their prognosis. Physician and external related factors, such as lack of training and lack of time for this conversation, were also described as important barriers. Participants with formal training regarding goals of care communication and with experience in palliative care perceived the lack of patients\u2019 advanced directives as a significant barrier and manifested more willingness to participate in decision-making about goals of care. The lack of access and of support for referral to palliative care was also considered a significant barrier for ACP and goals of care discussion.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The identification of barriers that limit the discussion of ACP and early palliative care referrals can certainly help to prioritise the next steps for future studies aimed at improving ACP and helping clinicians to better support patients through shared decision-making based on the patient\u2019s values and experiences.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12904-022-01052-w","type":"journal-article","created":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T14:16:41Z","timestamp":1663856201000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Advance care planning and goals of care discussion: the perspectives of Brazilian oncologists"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6714-1970","authenticated-orcid":false,"given":"Laiane Moraes","family":"Dias","sequence":"first","affiliation":[]},{"given":"Mirella Rebello","family":"Bezerra","sequence":"additional","affiliation":[]},{"given":"Williams Fernandes","family":"Barra","sequence":"additional","affiliation":[]},{"given":"Ana Em\u00edlia Vita","family":"Carvalho","sequence":"additional","affiliation":[]},{"given":"Lu\u00edsa","family":"Castro","sequence":"additional","affiliation":[]},{"given":"Francisca","family":"Rego","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2022,9,22]]},"reference":[{"issue":"10","key":"1052_CR1","doi-asserted-by":"publisher","first-page":"e844","DOI":"10.1200\/JOP.2016.018796","volume":"13","author":"JW Childers","year":"2017","unstructured":"Childers JW, Back AL, Tulsky JA, Arnold RM. 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