Avery C. Bechthold

Family caregivers of adults diagnosed with cancer usually face significant financial hardship due to employment disruptions and the cost of cancer-related

Background: Understanding what matters most to patients is central to person‐centered care, particularly in surgical oncology, where decisions often involve significant tradeoffs. We explored how surgeons elicit, integrate, document, and support patient values in cancer‐related decision‐making. Methods: This qualitative descriptive study involved semi‐structured interviews with surgical oncologists (June–September 2025). Participants were purposively sampled from a prior international survey to ensure variation in demographics. Interviews were recorded, transcribed, and analyzed using thematic analysis. Participant characteristics were summarized descriptively. Results: Fourteen surgeons participated. Most were male (71%), White (86%), and early‐career (43%), practicing primarily in gastrointestinal or hepatobiliary surgery (each 43%) at academic centers (57%) in the U.S. South or Midwest (each 36%). Surgeons described various approaches to eliciting values, including inferring values from contextual clues and clarifying tradeoffs between survival and quality‐of‐life. Values elicitation was largely situational, occurring in high‐risk or preference‐sensitive contexts. When values conflicted with recommendations, surgeons adapted plans within oncologic safety. Documentation varied and was shaped by relevance, medicolegal concerns, and workflow. Barriers included time limitations, emotional distress, family dynamics, and limited training. Conclusions: Values elicitation was inconsistent and situational rather than routine. More structured, earlier approaches and system‐level support may better align surgical decisions with patient values.

Background: Providing care aligned with patient values is key to high-quality cardiovascular care. However, it is unclear how recipients of a ventricular assist device (VAD) engage in values-centered discussions during the postimplantation period. Objective: To understand how recipients of a VAD engage in conversations focused on clarifying what matters most. Methods: Sequential explanatory mixed methods study. Adult recipients of a VAD were recruited from a Southeastern U.S. outpatient clinic. Participants completed a cross-sectional survey characterizing values discussions (with whom, who is present, timing, frequency, location, feelings). A subset completed a semi-structured interview to provide a richer understanding of survey findings. Results: Survey respondents (response rate 31%; N = 32) were 37 to 77 years, mostly male (59%) and non-Hispanic Black (53%). Qualitative analysis (n = 12) identified 3 themes: (1) Relational trust and emotional safety, (2) Timing and readiness, and (3) Contextual fit and communication environment. Synthesis of findings revealed congruence between survey and interview data. Patients indicated comfort with trusted, approachable individuals who were willing/able to offer support (with whom/who is present); acceptance and clarity about their new reality/identity (timing), trusting relationships built over time (frequency), and in-person interactions (location) were key; negative experiences emerged from frustration, conflict, negative attitudes, and lack of understanding (feelings). Conclusions: Findings highlight the importance of relational trust, emotional readiness, and a supportive communication environment in facilitating values-centered discussions and offer practical guidance for nurses to foster meaningful, values-centered discussions by prioritizing continuity, accessibility, and emotional safety in their interactions.