Clinical Judgement, Treatment Decisions and Frailty Management in Older Cancer Patients: A Qualitative Study Exploring the Experiences of Radiation Therapy Staff.
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| Titel: | Clinical Judgement, Treatment Decisions and Frailty Management in Older Cancer Patients: A Qualitative Study Exploring the Experiences of Radiation Therapy Staff. |
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| Autoren: | Axelsson S; Department of Oncology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.; University Health Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden., Fessé P; Center for Research & Development, Uppsala University/Region Gävleborg, Gävle, Sweden.; Sahlgrenska Academy, Institute of Health and Care Science, University of Gothenburg, Göteborg, Sweden., Fransson P; Department of Nursing, Umeå University, Umeå, Sweden., Schröder A; University Health Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.; Department of Nursing, Faculty of Health, Care and Nursing, Norwegian University of Science and Technology (NTNU), Gjøvik, Norway., Valachis A; Department of Oncology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden., Ohlsson-Nevo E; University Health Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.; Faculty of Medicine and Health, Department of Surgery, Örebro University Örebro, Örebro, Sweden. |
| Quelle: | Journal of medical radiation sciences [J Med Radiat Sci] 2025 Dec; Vol. 72 (4), pp. 504-511. Date of Electronic Publication: 2025 Aug 16. |
| Publikationsart: | Journal Article |
| Sprache: | English |
| Info zur Zeitschrift: | Publisher: Wiley Publishing Asia Pty Ltd Country of Publication: United States NLM ID: 101620352 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2051-3909 (Electronic) Linking ISSN: 20513895 NLM ISO Abbreviation: J Med Radiat Sci Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: [Malden, MA] : Wiley Publishing Asia Pty Ltd, [2013]- |
| MeSH-Schlagworte: | Neoplasms*/radiotherapy , Frailty*/therapy , Clinical Decision-Making* , Frail Elderly*, Humans ; Aged ; Qualitative Research ; Female ; Male ; Aged, 80 and over ; Decision Making |
| Abstract: | Introduction: Treatment of older cancer patients can be complex due to frailty that comes with age, and the benefits of radiation therapy for frail older patients are unclear. Radiation therapy staff play a crucial role in identifying and monitoring frailty and tailoring treatment. Research on radiation therapy in frail older patients is limited, and frailty assessments are not widely used in routine care. Understanding staff experiences with clinical judgement and frailty assessment is important for effective treatment. This study explored the radiation therapy staff's experiences of clinical judgement, treatment decision-making, and managing frail older cancer patients. Methods: The study has an inductive design in which 12 specialist oncology nurses and four clinical oncologists working with cancer patients at four radiation therapy units across four counties in Sweden were interviewed. In total, 16 participants were interviewed for the study. Data were collected in semi-structured individual interviews and were analysed using reflexive thematic analysis. Results: Three themes were identified from the interview analysis: Putting the patient first, Care with integrity and humanity and Receiving support in treatment decisions, along with nine sub-themes. None of the participants was using any structured instrument for assessing frailty. Conclusions: Radiation therapy staff face significant and complex challenges when treating frail older cancer patients, which can lead to feelings of doubt and powerlessness. Awareness and use of structured frailty assessment are limited. Integrating structured frailty assessment could address the complex challenges experienced by staff by improving decision-making, communication, and patient outcomes, contributing to more ethical and person-centred care. (© 2025 The Author(s). Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.) |
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| Grant Information: | OLL-972510 Regional Örebro County Research Committee; OLL-985063 Regional Örebro County Research Committee; OLL-990618 Regional Örebro County Research Committee |
| Contributed Indexing: | Keywords: decision‐making; experiences; frailty; geriatric assessment; radiation therapy staff |
| Entry Date(s): | Date Created: 20250816 Date Completed: 20251128 Latest Revision: 20251130 |
| Update Code: | 20251130 |
| PubMed Central ID: | PMC12661082 |
| DOI: | 10.1002/jmrs.70017 |
| PMID: | 40817685 |
| Datenbank: | MEDLINE |
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Nájsť tento článok vo Web of Science | Abstract: | Introduction: Treatment of older cancer patients can be complex due to frailty that comes with age, and the benefits of radiation therapy for frail older patients are unclear. Radiation therapy staff play a crucial role in identifying and monitoring frailty and tailoring treatment. Research on radiation therapy in frail older patients is limited, and frailty assessments are not widely used in routine care. Understanding staff experiences with clinical judgement and frailty assessment is important for effective treatment. This study explored the radiation therapy staff's experiences of clinical judgement, treatment decision-making, and managing frail older cancer patients.<br />Methods: The study has an inductive design in which 12 specialist oncology nurses and four clinical oncologists working with cancer patients at four radiation therapy units across four counties in Sweden were interviewed. In total, 16 participants were interviewed for the study. Data were collected in semi-structured individual interviews and were analysed using reflexive thematic analysis.<br />Results: Three themes were identified from the interview analysis: Putting the patient first, Care with integrity and humanity and Receiving support in treatment decisions, along with nine sub-themes. None of the participants was using any structured instrument for assessing frailty.<br />Conclusions: Radiation therapy staff face significant and complex challenges when treating frail older cancer patients, which can lead to feelings of doubt and powerlessness. Awareness and use of structured frailty assessment are limited. Integrating structured frailty assessment could address the complex challenges experienced by staff by improving decision-making, communication, and patient outcomes, contributing to more ethical and person-centred care.<br /> (© 2025 The Author(s). Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.) |
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| ISSN: | 2051-3909 |
| DOI: | 10.1002/jmrs.70017 |