"Hopes and wishes": Goals of high-need, high-cost older patients and their caregivers.
Mary F Wyman, Daniel Liebzeit, Corrine I Voils and 8 others
PMID 32098745WHAT IT FOUND
Older high-need patients and caregivers named hopes and wishes, not goals: pain relief, autonomy, less treatment burden, meaningful activity, relationships, legacy, and financial or housing security.
Key findings
01Participants usually described what they hoped to achieve as hopes, wishes, or wants rather than as goals.
02Goals were not static, and some participants re-calibrated them depending on current priorities and how they were feeling.
03Decreasing treatment burden and financial or housing security emerged as goal categories.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The original interviews were not designed to saturate on goals, because this was a secondary analysis. The final categories were not member-checked with patients or caregivers; feedback came from clinical partners. Only four caregivers participated, so caregiver views may not be representative. Participants came from four sites in one midwestern U.S. health system, so the findings may not apply elsewhere. The study describes goals but does not show that any care approach improves outcomes.
Declared interests
The supplied article text does not include a conflict-of-interest declaration. The journal metadata lists NIH and other research support.
The easy way to misread this
Do not read the eight goal categories as proof that asking patients about goals improves outcomes. The study was qualitative and did not test an intervention or measure patient results.