Goals of care toward the end of life: a structured literature review.
Goals of care are often mentioned as an important component of end-of-life discussions, but there are diverse assessments regarding the type and number of goals that should be considered. To address this lack of consensus, we searched MEDLINE (1967-2007) for relevant articles and identified the number, phrasing, and type of goals they addressed. An iterative process of categorization resulted in a list of 6 practical, comprehensive goals: (1) be cured, (2) live longer, (3) improve or maintain function/quality of life/ independence, (4) be comfortable, (5) achieve life goals, and (6) provide support for family/caregiver. These goals can be used to articulate goal-oriented frameworks to guide decision making toward the end of life and thereby harmonize patients' treatment choices with their values and medical conditions.
Kaldjian
Lauris C
LC
Department of Internal Medicine, Division of General Internal Medicine, University of Iowa Carver College of Medicine, 500 Newton Road, Iowa City, IA 52242, USA. lauris-kaldjian@uiowa.edu
Curtis
Ann E
AE
Shinkunas
Laura A
LA
Cannon
Katrina T
KT
D000203:Activities of Daily Living / Q000523:psychology; D032722:Advance Care Planning; D001293:Attitude to Death; D003142:Communication; D003657:Decision Making; D005190:Family / Q000523:psychology; D006040:Goals; D006801:Humans; D007398:Interpersonal Relations; D008020:Life Support Care; D008136:Longevity; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010347:Patient Care Planning / Q000458:organization & administration*; D010358:Patient Participation; D018802:Patient-Centered Care / Q000458:organization & administration; D011788:Quality of Life / Q000523:psychology; D012944:Social Support; D029181:Spirituality; D013727:Terminal Care / Q000458:organization & administration* / Q000523:psychology