Neoplasms

Skin and Connective Tissue Diseases

All Conditions

Symptoms and General Pathology

Breast Neoplasms

Recurrence

Breast Diseases

Skin Diseases

Prognosis discussion intervention with study team.

T-PAT

Pre-test and posttest surveys and questionnaires

Surveys

Mary Step, PhD

This research study will examine how patients with advanced breast cancer and their oncology team communicate and plan ongoing care.The purpose of this study is to find out more about care planning during advanced breast cancer. The study will see if certain aspects of communication make a difference in how patients understand their illness.

The new communication practice (T-PAT) is a team approach for discussing prognosis and treatment goals. T-PAT is specifically designed to a) increase understanding of the prognosis and treatment goal, b) decrease illness uncertainty, and c) help the patient preserve hope for the future.This dedicated clinical visit features a structured discussion of prognosis, treatment goals and options, and end of life concerns. The planned team discussion will include information contributions for the treating medical oncologist, an oncology nurse and social worker who currently work together to provide breast cancer care.

Primary Objectives:

1. Assess the feasibility of implementing the T-PAT prognosis discussion intervention.
2. Compare the effects of T-PAT vs. usual care on pertinent patient reported outcomes including: a) understanding of the prognosis and treatment goal, b) illness uncertainty, and c) hope.

   * First, a survey will be administered to patients in the waiting room before the next office visit. This should take 15-20 minutes.
   * The second part involves participating in a scheduled appointment that will be audio-recorded and focus on sharing information about the patient's illness. Patients will be randomized to either participate in an appointment featuring new communication practices (T-PAT)or a regular care appointment.
   * The third part involves a 20 minute survey, after the appointment, with a member of the study staff. This will take place over the telephone one or two days after the appointment.
   * The fourth part is completion of a written reflection on the patients participation in the study, which will be returned in a pre-addressed, stamped envelope. Generally, this should take about 15 minutes.

Feasibility of a Team Approach for Discussing Prognosis and Treatment Goals in Breast Cancer

Feasibility of a Team Approach for Discussing Prognosis and Treatment Goals With Patients Diagnosed With Advanced Breast Cancer

Accuracy and completion rate of the planned intervention components will be observed.

Using the Snyder et al.'s State Hope Scale

Six-Item scale that measures motivation to endure burden associated with aggressive care. Higher scores indicate a greater willingness to tolerate adverse states.

Assess patients perceptions about prognosis independent of what they recall being told by their doctor.

16-item scale tapping patient uncertainty about symptoms, diagnosis, treatment, and future plans.

Patients will be asked to report their preference for aggressive care.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Feasibility of a Team Approach for Discussing Prognosis and Treatment Goals in Breast Cancer	NCT01876238	Advanced Breast... Stage 4 Breast ... Recurrent Breas...	T-PAT Surveys	18 Years -	Case Comprehensive Cancer Center
Feasibility of a Team Approach for Discussing Prognosis and Treatment Goals in Breast Cancer	NCT01876238	Advanced Breast... Stage 4 Breast ... Recurrent Breas...	T-PAT Surveys	18 Years -	Case Comprehensive Cancer Center

Spots Global Cancer Trial Database for stage 4 breast cancer