Evaluation d’une stratégie multimodale d’information et de recueil des directives anticipées dans un Centre de Lutte Contre le Cancer: description du protocole de l’étude

Background: Information on the possibility of drawing up Advance Directives (AD) is a necessity, and represents a major medical, ethical, and legal challenge. The difficulties are numerous, both organizational and cultural, and this is also true in the context of oncology, where ADs (and more broadly, advanced palliative care) are of critical importance. As an eminently sensitive subject, dealing with ADs (and therefore with end-of-life issues) requires both societal and medical/health-care acculturation. An institutional approach has therefore been developed, to deploy information tools, training professionals, and formalize the collection of AD. Such an approach cannot be implemented without an assessment not only of its objective results but also above all of its psychological effects, on both users (patients, family caregivers) and professionals. Methods: This longitudinal study, based on a mixed-method, interdisciplinary approach, will assess the impact of this information dissemination on AD, in terms of both potential positive and negative effects, using validated measurement methods. Thus, this study follows the 5 criteria of the RE-AIM model, designed to analyze the interest and impact of a device intended for users of the healthcare system; we will use a mixed methodology, relying on both a quantitative component (counting the number of people benefiting from the scheme, and those requesting support in drawing up their DA…, administering questionnaires), as well as a qualitative component (focus groups) which will enable us to study the subjective experiences of users, their relatives and the professionals involved in the scheme. Results: The results of this study will make it possible to determine the effects of this system of assistance in the drafting of ADs, which is currently being promoted by the legislator, but which is struggling to be implemented.