Table 1.

The Key Themes That Comprise the Operational Definition of “Goals of Care”

Key theme	Exemplary quotes
Overarching aims	“Goals of care point to a general direction of what is hoped to be achieved through the provision of care.”
	“[…] the goal speaks to the overarching aim of care. The goal of care indicates the destination and the care plan, how to get there.”
Patient values and priorities	“It is therefore crucial for the health care professional who cares for patients with chronic diseases to be able to elicit underlying values and priorities, to set overall goals for care.”
	“Goals of care was conceptually defined as ‘an understanding of what is most important to the patient in order to allow the clinician to align the care provided accordingly.’”
Clinical context	“Concurrently, patients must have an understanding of their illness to meaningfully reflect on their goals of care (GoC) and effectively participate in shared decision making.”
	“Goals of care are important because they provide a basic orientation for decision making and can guard against tendencies to isolate interventions from the larger clinical realities that surround them.”
Medical intervention decisions	“Goals of care are increasingly recommended as a means to inform and guide discussions between patients, their families, and clinicians about treatment and diagnostic decisions.”
	“Once the goals of care have been agreed on, however, it does become easier to evaluate specific treatments because one can think about the extent to which a particular therapy or course of action helps everyone move toward those goals of care.”
	“Absent a strong sense of the overall goal of care, each medical decision may be approached “piecemeal” without a sense of how a specific medical intervention contributes to or detracts from the main aim of care.”
Relationship among key GOC themes	“GOC conversations are intended to align treatments, decisions and care plans with a patient’s values, preferences and understandings given their current clinical circumstances.”
	“Discussions regarding goals of care help patients and their families understand the nature of the patient’s illness and its trajectory and to make decisions on parameters of medical care that are consistent with the patient’s values and goals.”

GOC goals of care