Mariken Stegmann

Therefore, in this thesis I will present the results of two research projects: 1) The OPTion  project which focuses at shared decision making and 2) PION which focuses at information  exchange between doctors. The ultimate aim is to make suggestions for improvements in  different types of communication.  In chapter 2, I will describe the protocol of the OPTion‐study, a randomised controlled trial  (RCT). In this study older patients with a palliative cancer diagnosis were randomly assigned  to either a care as usual group or an intervention group. The intervention was an OPT‐ conversation with their GP, using the Outcome Prioritisation Tool to discuss treatment goals.  In chapter 3, the instrument OPT and its use are described in detail, as well as a review of  the existing literature about this instrument. In chapter 4, I will report the results of the  OPTion‐RCT: the effect of the aforementioned OPT‐conversation on patient empowerment  and on symptoms of anxiety, depression and fatigue. In chapter 5, I will describe treatment  goals of older patients with non‐curable cancer, whether they changed over time, and what  triggered these changes..  In chapter 6, I will present the first part of the PION‐study (Patient Information exchange in  ONcology). In this qualitative study we analysed medical files containing referral and  specialist letters of patients with lung, breast or colorectal cancer. We examined what  information was shared and what information was not shared between primary and  secondary care during diagnosis and the initial therapy phase. In chapter 7, the second part  of the PION‐study, I will describe a Delphi study with panels of specialists, GPs and patients  in which they decided which items are essential and which items are redundant in their  correspondence.  In the last chapter, chapter 8, I will provide a summary and discuss the findings and their  implications.   1 13 General introduction