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@ARTICLE{Siegle:136930,
      author       = {A. Siegle$^*$ and M. Villalobos and J. Bossert and K. Krug
                      and L. Hagelskamp$^*$ and J. Krisam and V. Handtke and N.
                      Deis and J. Jünger and M. Wensing and M. Thomas},
      title        = {{T}he {H}eidelberg {M}ilestones {C}ommunication {A}pproach
                      ({MCA}) for patients with prognosis $\<12 months:$ protocol
                      for a mixed-methods study including a randomized controlled
                      trial.},
      journal      = {Trials},
      volume       = {19},
      number       = {1},
      issn         = {1745-6215},
      address      = {London},
      publisher    = {BioMed Central},
      reportid     = {DKFZ-2018-01367},
      pages        = {438},
      year         = {2018},
      abstract     = {The care needs of patients with a limited prognosis
                      (<12 months median) are complex and dynamic. Patients and
                      caregivers must cope with many challenges, including
                      physical symptoms and disabilities, uncertainty. and
                      compromised self-efficacy. Healthcare is often characterized
                      by disruptions in the transition between healthcare
                      providers. The Milestones Communication Approach (MCA) is a
                      structured, proactive, interprofessional concept that
                      involves physicians and nurses and is aimed at providing
                      coherent care across the disease trajectory. This study aims
                      to evaluate these aspects of MCA: (1) the training of
                      healthcare professionals, (2) implementation context and
                      outcomes, (3) patient outcomes, and (4) effects on
                      interprofessional collaboration.A multiphase mixed-methods
                      design will be used for the study. A total of 100 patients
                      and 120 healthcare professionals in a specialized oncology
                      hospital will be involved. The training outcomes will be
                      documented using a questionnaire. Implementation context and
                      outcomes will be explored through semi-structured interviews
                      and written questionnaires with healthcare professionals and
                      with the training participants and through a content
                      analysis of patient files. Patient outcomes will be assessed
                      in a pragmatic non-blinded randomized controlled trial and
                      in qualitative interviews with patients and caregivers.
                      Trial outcomes are supportive care needs (SCNS-SF34-G),
                      quality of life (SeiQol and Fact-L), depression and anxiety
                      symptoms (PHQ-4), and distress (Distress Thermometer).
                      Qualitative semi-structured interviews on patients' views
                      will focus on shared decision-making, communication needs,
                      feeling empathy, and further utilization of healthcare
                      services. Interprofessional collaboration will be explored
                      using the UWE-IP-D before the implementation of MCA (t0) and
                      after 3 (t1), 9 (t2), and 12 (t3) months.Using
                      guideline-concordant early palliative care, MCA aims to
                      foster patient-centered communication with shared
                      decision-making and facilitation of advance care planning
                      including end-of-life decisions, thus increasing patient
                      quality of life and decreasing aggressive medical care at
                      the end of life. It is assumed that the communication skills
                      training and interprofessional coaching will improve the
                      communication behavior of healthcare providers and influence
                      team communications and team processes.German Clinical
                      Trials Register, DRKS00013649 and DRKS00013469. Registered
                      on 22 December 2017.},
      cin          = {G835},
      ddc          = {610},
      cid          = {I:(DE-He78)G835-20160331},
      pnm          = {317 - Translational cancer research (POF3-317)},
      pid          = {G:(DE-HGF)POF3-317},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:30107809},
      pmc          = {pmc:PMC6092809},
      doi          = {10.1186/s13063-018-2814-1},
      url          = {https://inrepo02.dkfz.de/record/136930},
}