European journal of cancer (Oxford, England : 1990) vol:31A Suppl 6 pages:S11-4
Quality of care and quality of life are patient-centred, whereas medical education tends to be disease-centred. More patient-centred models will be necessary to optimise the quality of care for cancer patients. This demands new priorities in medical education, new concepts for structuring and organising responsibilities in medical care, and new complementary task definitions for the players involved. Goal setting and functional care models are conceptual innovations that can help introduce the patient-centred approach into medical practice. In the care of patients with cancer, the goals of the physician, nurse, patient, and family may change and diverge as the disease progresses, necessitating open discussion and bargaining. Functional care models stress that the quality of care can be defined differently at the four different levels of care-medical, nursing, cleaning/providing, and support from family and friends. Instruments that maintain the focus of care on the patient's quality of life can help formalise the goal-setting process. Quality of life measuring instruments should be adapted to the priorities of the clinical situation and implemented in basic practice routines. There is no single objective quality of life level or score, and measuring instruments must take into account different quality of life options. Multidisciplinarity and multimedia education means the appropriate learning instruments at the appropriate time for all those concerned.