1 19 We specifically focused on a model with five key elements identified by others as crucial to successful advance care planning 16 21 35: trained facilitators, patient centred discussions, involvement of family in discussions, correctly filed documentation, and systematic education of doctors.
Project-centred discussion and activity was linked to debate and mobilisation around wider issues.
In conjunction with a subsequent care plan, the process supports timely intervention based on a collaborative, person-centred discussion.
Most interviewees said they would have liked sufficient information and time to allow more patient-centred discussion at the MDT meeting, but they did not necessarily consider the meeting's narrow focus on cancer pathology as a major deficiency or problem.
Given that the qualitative findings suggest variability in the delivery of the BI and use of MI techniques, further research is warranted to evaluate the actual counselling content and quality of patient-centred discussions at each step of the intervention.
Such monitoring appointments are not conducive to patient-centred discussions and the work needed to establish a partnership where challenges can be made by both partners concerning lifestyle change may be considered too disruptive to relationships for health care professionals to initiate and trust is hard to establish [ 14, 47, 48].
They performed less well in relation to spending adequate time discussing cases (requiring case prioritisation on the agenda), and having patient-centred case discussions.
A key concern within feminist writing about ultrasound is that pregnant women are erased from ultrasound images (Petchesky 1987), facilitating "fetal-centred" (Steinberg 1991, 179) discussion of abortion.
The discussion should centre on how well trusts can deliver high-quality, person-centred care through alternative approaches.
Health education messages to promote early help-seeking in biomedical facilities for cervical cancer symptoms, and private consultations need to be patient-centred and culturally sensitive; and discussion points need to cautiously and respectfully include rather than avoid any inappropriate community beliefs about cervical cancer, perceived causes and treatment modalities.
