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Refinement of a Conceptual Model for Adolescent Readiness to Engage in End-of-Life Discussions.

Publication ,  Journal Article
Bell, CJ; Zimet, GD; Hinds, PS; Broome, ME; McDaniel, AM; Mays, RM; Champion, VL
Published in: Cancer nursing
March 2018

Adolescents living with incurable cancer require ongoing support to process grief, emotions, and information as disease progresses including treatment options (phase 1 clinical trials and/or hospice/palliative care). Little is known about how adolescents become ready for such discussions.The purpose of this study was to explore the process of adolescent readiness for end-of-life preparedness discussions, generating a theoretical understanding for guiding clinical conversations when curative options are limited.We explored 2 in-depth cases across time using case-study methodology. An à priori conceptual model based on current end-of-life research guided data collection and analysis. Multiple sources including in-depth adolescent interviews generated data collection on model constructs. Analysis followed a logical sequence establishing a chain of evidence linking raw data to study conclusions. Synthesis and data triangulation across cases and time led to theoretical generalizations. Initially, we proposed a linear process of readiness with 3 domains: a cognitive domain (awareness), an emotional domain (acceptance), and a behavioral domain (willingness), which preceded preparedness.Findings led to conceptual model refinement showing readiness is a dynamic internal process that interacts with preparedness. Current awareness context facilitates the type of preparedness discussions (cognitive or emotional). Furthermore, social constraint inhibits discussions.Data support theoretical understanding of the dynamism of readiness. Future research that validates adolescent conceptualization will ensure age-appropriate readiness representation.Understanding the dynamic process of readiness for engaging in end-of-life preparedness provides clinician insight for guiding discussions that facilitate shared decision making and promote quality of life for adolescents and their families.

Duke Scholars

Published In

Cancer nursing

DOI

EISSN

1538-9804

ISSN

0162-220X

Publication Date

March 2018

Volume

41

Issue

2

Start / End Page

E21 / E39

Related Subject Headings

  • Young Adult
  • Terminal Care
  • Quality of Life
  • Palliative Care
  • Nursing
  • Models, Theoretical
  • Male
  • Humans
  • Grief
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
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Bell, C. J., Zimet, G. D., Hinds, P. S., Broome, M. E., McDaniel, A. M., Mays, R. M., & Champion, V. L. (2018). Refinement of a Conceptual Model for Adolescent Readiness to Engage in End-of-Life Discussions. Cancer Nursing, 41(2), E21–E39. https://doi.org/10.1097/ncc.0000000000000465
Bell, Cynthia J., Gregory D. Zimet, Pamela S. Hinds, Marion E. Broome, Anna M. McDaniel, Rose M. Mays, and Victoria L. Champion. “Refinement of a Conceptual Model for Adolescent Readiness to Engage in End-of-Life Discussions.Cancer Nursing 41, no. 2 (March 2018): E21–39. https://doi.org/10.1097/ncc.0000000000000465.
Bell CJ, Zimet GD, Hinds PS, Broome ME, McDaniel AM, Mays RM, et al. Refinement of a Conceptual Model for Adolescent Readiness to Engage in End-of-Life Discussions. Cancer nursing. 2018 Mar;41(2):E21–39.
Bell, Cynthia J., et al. “Refinement of a Conceptual Model for Adolescent Readiness to Engage in End-of-Life Discussions.Cancer Nursing, vol. 41, no. 2, Mar. 2018, pp. E21–39. Epmc, doi:10.1097/ncc.0000000000000465.
Bell CJ, Zimet GD, Hinds PS, Broome ME, McDaniel AM, Mays RM, Champion VL. Refinement of a Conceptual Model for Adolescent Readiness to Engage in End-of-Life Discussions. Cancer nursing. 2018 Mar;41(2):E21–E39.

Published In

Cancer nursing

DOI

EISSN

1538-9804

ISSN

0162-220X

Publication Date

March 2018

Volume

41

Issue

2

Start / End Page

E21 / E39

Related Subject Headings

  • Young Adult
  • Terminal Care
  • Quality of Life
  • Palliative Care
  • Nursing
  • Models, Theoretical
  • Male
  • Humans
  • Grief
  • Female