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INTRODUCTION

Breast cancer, the most common cancer in women, also affects young women. Advance directives allow individuals to express their end-of-life wishes, but they are often poorly drafted. General practitioners report significant difficulties in discussing end-of-life issues.

PURPOSE: This study aims to propose a model of advance directives that facilitates dialogue between physicians and breast cancer patients.

METHODS

The model was developed through a Delphi consensus among 21 experts. The Delphi process consisted of three rounds. The panel of experts consisted of health care professionals working with breast cancer patients, a doctor of sociology, the deputy director of the National Center for Palliative Care and End-of-Life Care, and a former cancer patient who is president of an association. The resulting model integrates patients' moral values, care preferences, and social environment in a more personalized manner.

RESULTS

The first round lasted three weeks. Of 29 questions, 20 were rated relevant by over 70% of experts. The second round lasted four weeks, during which nine reworded questions were addressed, and eight were validated. The final question was validated in the third round. All experts participated in all three rounds.

CONCLUSION

The proposed model serves as a tool to foster more effective communication between physicians and patients, aiming to faithfully reflect patients' wishes regarding end-of-life care.