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Evaluation of an advance care planning web-based resource: applicability for cancer treatment patients



The purpose of this study was to explore the acceptability, applicability, and understandability of a promising advance care planning (ACP) web-based resource for use with oncology patients, and determine whether revisions to the website would be necessary before implementation into oncology care. The resource is called PREPARE ( and it had not been tested for use within oncology, but had previously been shown to influence the readiness of older, community-dwelling adults to engage in ACP behaviors.


This qualitative descriptive study included participants receiving cancer medications and one participant on watchful waiting post-chemotherapy (n = 21). Data were collected via cognitive interviewing, followed by a brief semi-structured interview to gather a meaningful account of the participants’ experience with PREPARE. Content analysis resulted in a comprehensive summary of what participants liked and did not like about the resource, as well as suggestions for change.


Overall, participants agreed PREPARE was acceptable, applicable, and understandable for cancer patients. A small number of participants had difficulty with the life-limiting language found within the website and this requires follow-up to determine whether the language causes distress or disengagement from ACP. These findings extend our understanding of barriers to engagement in ACP that appear unique to cancer patients receiving active treatment.


Results indicated that PREPARE is a reflective, capacity-building ACP resource that was acceptable, applicable, and understandable for use in oncology. These findings offer direction for both research and practice.

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The research was partially funded by a grant from the British Columbia Cancer Foundation (H13-02044; PI Robinson).

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Corresponding author

Correspondence to Carole A. Robinson.

Ethics declarations

The study was approved by the University Behavioral Research Ethics Board.

Conflict of interest

The study was partially funded by a grant from the British Columbia Cancer Foundation (H13-02044; PI Robinson). The authors do not have competing financial interests or a financial relationship with the sponsoring agency. Dr. Robinson has full control of all primary data and agrees to allow the journal to review the data if requested.

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Cresswell, M.A., Robinson, C.A., Fyles, G. et al. Evaluation of an advance care planning web-based resource: applicability for cancer treatment patients. Support Care Cancer 26, 853–860 (2018).

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  • Advance care planning
  • Oncology
  • Cancer
  • Active treatment
  • Intervention
  • Evaluation