Creating an appropriate model of advance care planning for women with breast cancer, Delphi method

Abstract

Abstract Introduction: Breast cancer, the most common cancer in women, affects young women. Advance directives allow the expression of one's wishes concerning end of life wishes but they are poorly drafted. General practitioners report, in fact, real difficulties in talking about the end of life. Purpose This study aims to propose a model of advance directives that facilitates the exchange between the doctor and a breast cancer patient. Methods It is the result of a consensus of experts, obtained by the Delphi method. Twenty-one experts were included. A Delphi survey consisting of three rounds. The panel of experts were caregivers in contact with breast cancer patients, a Doctor of Sociology, deputy director of the National Center for Palliative Care and End of Life, as well as a former patient in remission from cancer. breast, association president. This new innovative model obtained takes into account in a more intimate way the moral values, the wishes of care and their environment. Results The first round lasted three weeks. Of the 29 questions posed to the experts, 20 were deemed relevant by over 70% of the experts. The second round lasted four weeks. Nine reworded questions were addressed to the experts. Eight of them were validated. The last question was validated in the third round. All experts responded to all three rounds. Conclusion The model created is a tool to create a more efficient dialogue between the physician and the patient. It is intended to be a faithful testimony of the patients’ wishes.