Qualitative analysis of concordance in advance care planning discussions between patients with advanced cancer and their surrogate decision makers

Objectives
This study aimed to explore the concordance in advance care planning (ACP) discussions between patients with advanced cancer and surrogate decision makers within an oncology ward.

Design
Purposive and snowball sampling methods were used in this qualitative study, which involved conducting semistructured interviews to gather patients with advanced cancer and their surrogate decision makers. Interpretative phenomenological analysis was performed on the interview data to identify commonalities and differences in ACP discussions and to explore the factors influencing these differences.

Setting
The research was conducted in the oncology ward of a tertiary hospital located in Foshan, China.

Participants
Participants included a total of 15 pairs of patients with advanced cancer and their surrogate decision makers in oncology wards.

Results
Interpretative phenomenological analysis yielded three main themes and fourteen subthemes. The identified themes were: (1) personal factor; (2) family intrinsic factors and (3) external factor.

Conclusion
This study revealed the consistency of ACP between patients with advanced cancer and their surrogate decision makers in China and its influencing factors. Future research should further explore family-centred ACP practices, delve into how family factors influence the implementation of ACP for patients and develop conceptual frameworks and implementation strategies for ACP that align with Chinese cultural values and healthcare systems. These efforts will contribute to enhancing understanding in clinical practice, advancing scientific research and guiding policy formulation. ACP holds promise as a crucial intervention to improve the quality of end-of-life care for patients with advanced cancer in China, playing a central role in the field of palliative care in the country.

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Considerations of equity in the development of tools that identify and respond to end-of-life carer support needs: a scoping review protocol

Introduction
Informal caregivers are essential in supporting end-of-life patients at home but are often ill-prepared for the carer role. There is growing interest in the development of tools to assess caregiver support needs and a recognised need for a greater focus on addressing inequities in end-of-life care. We plan to undertake a scoping review of available literature to (1) identify and describe tools developed to assess the support needs of informal caregivers in end-of-life care; (2) report on any inequities and under-represented groups in tool development and use.

Methods and analysis
The review will conform to best practice methodological guidance (Joanna Briggs Institute) for scoping reviews. The search strategy will target published and unpublished studies using any methodology, which reports on developing or using tools or measures to assess informal carer support needs in end-of-life/palliative care settings. The following databases will be searched: MEDLINE, CINAHL, PsycINFO, Web of Science, ASSIA and Proquest. Both title/abstract screening and full-text assessment will be undertaken to ensure eligibility. Searches will be conducted between May and December 2024. We will extract data relating to (1) tools/measures identified, and outcome measures used to assess these; (2) participant characteristics. Extracted data will be tabulated with accompanying narrative description to address the review objectives. Data will be extracted and write-up will be completed between January and May 2025.

Ethics and dissemination
This scoping review will provide an overview of the tools developed to identify and assess informal caregiver support needs in palliative and end-of-life care. The identification of any inequities will increase awareness of potentially underserved groups and contexts within the current literature, highlighting how future research and resource can be more equitably focused and implemented in a way that does not further embed disparity. Findings will be made publicly available through the Open Science Framework and disseminated through a peer-reviewed publication. As a scoping review of available literature, this work does not require ethical approval.

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Stool Metabolites Could Aid in Endometriosis Diagnosis and Therapy

Women with endometriosis—a painful condition with no cure that is a leading cause of infertility—have distinct stool metabolites that could be used for noninvasive diagnoses, according to research recently published in Med. A metabolite that is reduced in these women, meanwhile, has implications for treatment, the authors reported.

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