Background: Whether it is completing a marathon or taking a cruise to celebrate a 50th wedding anniversary, life goals are essential for optimal health and well-being. A cancer diagnosis commonly interrupts life goals due to side effects from treatment or the illness itself (Janse et al., 2016). There are organizations such as Make-A-Wish that work to help pediatric cancer patients achieve life goals. However, the most commonly used screening tool, the National Comprehensive Cancer Network Distress Thermometer, does not address a patient’s life goals (NCCN, 2018). Studies are limited on the impact of cancer on life goals, and the majority of tools used were author developed, making it hard to compare across studies (Hullman, Robb & Rand, 2016). Unless an organization has developed a life goal screening tool or the care team has had a conversation that specifically addresses life goals, an opportunity may have been missed to support the patient to achieve their life goals and improve their quality of life.
Objectives: To develop a tool that can be used to identify a patient’s life goals and priorities. That will enable the care team and nurse navigator to assess life goals and priorities and goal disturbance and to implement goal adjustment strategies.
Methods: Current psychosocial tools were evaluated that addressed life goals and values. In addition, consultations with palliative care and social work helped guide the development. Three psychosocial tools and 3 studies related to cancer and setting life goals were identified as relevant to the purposes of tool development.
Results: The “Patient Wellness Assessment” tool was created from the identified key areas of life goals—defining living well, priorities/passions, what has changed since their diagnosis, creating new goals or adjusting prior goals, and listing what is valuable to the patient.
Conclusion: The long-term intention is that the tool will be shared with care providers to guide treatment planning in alignment with patients’ life goals and values. The Sarah Cannon/HealthONE market in Denver treats over 5000 patients annually and provides patient navigation for multiple cancer sites. Due to the patient volumes and patient navigation program, a large quantitative study could be performed to evaluate the effectiveness of the tool. Current implementation status is in the preliminary stage, which includes defining the appropriate population, narrowing study group, documentation strategies, developing adjustment strategies, suitable intervention care point, and how to measure impact.
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Janse M, Ranchor A, Smink A, et al. People with cancer use goal adjustment strategies in the first 6 months after diagnosis and tell us how. Br J Health Psychol. 2016;21:268-284.
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