Journal Article

Casemanagers Positioned as Key Advance Care Planning Conversationalists in Oncology Care: A Qualitative Interview Study on the Perspectives of Healthcare Professionals and Patients

Engels, Yvonne, Kuip, Evelien, Putker, Anouk, Perry, Marieke, Piek, Annika, Chalkiopoulos, Jelmer

2025

Overview

ABSTRACT Introduction The increasing global cancer burden and advances in treatments have extended patients' life expectancy, leading to greater prognostic uncertainty and a higher demand for palliative care. Advance care planning (ACP) is essential in this context, ensuring that patients' future care aligns with their values and preferences. Oncology case managers, being nurses with specialized training, have emerged as key ACP conversationalists. This study explores the perspectives of healthcare professionals and patients on case managers as ACP conversationalists for advanced cancer patients. Methods A qualitative interview study was conducted with 12 patients who recently had an ACP conversation with their case managers and 12 healthcare professionals, including medical oncologists and case managers, at a university medical center in the Netherlands. Transcripts of semi‐structured interviews were analyzed using inductive thematic analysis. Results Three main themes emerged: (1) Trust as the foundation for effective ACP, where patients valued the casemanagers' familiarity and accessibility; (2) ACP aligns with the competencies and tasks of the casemanager, as their communication skills and disease knowledge were seen as strengths; (3) Challenges related to responsibility around treatment decisions and the reluctance of medical oncologists to relinquish control of the conversation. Both patients and professionals recognized the importance of casemanagers having ACP conversations. Conclusions Casemanagers are well‐positioned to lead ACP conversations in oncology care, offering trust, continuity, and expertise. Despite some concerns regarding responsibility and medical decision‐making, their role can improve the quality of ACP, supporting more personalized and timely palliative care.

• Publisher: John Wiley & Sons, Inc,Wiley
• Subject: Adult / Advance Care Planning / Advance directives / Aged / Attitude of Health Personnel / Cancer / casemanagers / Communication / Decision making / Familiarity / Female / Females / Health care / Health care policy / Health Personnel - psychology / Hospitals / Humans / Interdisciplinary aspects / Interviews / Interviews as Topic / Life span / Male / Medical Oncology / Medical personnel / Medical research / Medical students / Middle Aged / Neoplasms - psychology / Neoplasms - therapy / Netherlands / nursing / Oncology / Palliation / Palliative Care / Patients / Physician-Patient Relations / Professionals / Qualitative Research / Quality of life / Research methodology / Shared decision making / Verbal communication