UBC Theses and Dissertations

UBC Theses Logo

UBC Theses and Dissertations

Evaluation of a web-based tool designed to prepare people for treatment decisions and advance care planning : applicability in oncology Cresswell, Martha


Health care delivery is structured around patient-centered care and the expectation that patients will exercise autonomous medical decision making, however many oncology patients who access health care have no preparation for making informed treatment decisions or engaging in advance care planning (ACP) conversations. Engagement in ACP conversations facilitates patient-centred care that is consistent with the care and treatment the patient wants and enables in-the-moment medical decisions during treatment and at end of life. Patient engagement in ACP is associated with a measure of high quality care delivery by legal standards, clinical guidelines and ethical consensus. The majority of Canadians acknowledge the importance of ACP, but do not benefit from it because they are not engaging in ACP discussions or documentation. This study addressed the need to find an acceptable and relevant means to engage cancer patients in ACP. PREPARE is a promising web-based intervention aimed at preparing patients to engage in ACP discussions that was developed with community dwelling seniors in the United States. It had not been evaluated for use with an oncology population. The purpose of this qualitative descriptive study was to evaluate the acceptability, applicability, and understandability of PREPARE for cancer patients. Data was collected via cognitive interviewing, followed by a brief semi-structured interview with 21 participants to gather a meaningful account of their experience with the PREPARE website. Content analysis resulted in a comprehensive summary of what the participants liked and did not like about the resource, as well as suggestions for change. The active cancer treatment patients enrolled in this study indicated that the PREPARE website was acceptable, applicable, and understandable for an oncology population. Importantly, this was the case for both older and middle aged participants. Some participants had difficulty with the life limiting language of “life not worth living or worse than death” and this requires follow-up in order to determine whether changes to the resource are needed. However, overall, PREPARE was found to be a useful reflective resource for cancer patients that merits further consideration for implementation.

Item Citations and Data


Attribution-NonCommercial-NoDerivs 2.5 Canada