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'Not yet' and 'Just ask': barriers and facilitators to advance care planning--a qualitative descriptive study of the perspectives of seriously ill, older patients and their families.
BMJ Support Palliat Care. 2015 Mar; 5(1):54-62.BS

Abstract

OBJECTIVES

To explore seriously ill, older hospitalised patients' and their family members' perspectives on the barriers and facilitators of advance care planning (ACP).

METHODS

We used qualitative descriptive study methodology to analyse data from an interviewer administered, questionnaire-based, Canadian multicentre, prospective study of this population.

RESULTS

Three main categories described these barriers and facilitators: (1) person (beliefs, attitudes, experiences, health status), (2) access (to doctors and healthcare providers, information, tools and infrastructure to communicate ACP preferences) and (3) the interaction with the doctor (who and how initiated, location, timing, quality of communication, relationship with doctor).

CONCLUSIONS

Based on the findings, we suggest strategies for both healthcare systems and individual healthcare providers to improve the quality and quantity of ACP with this population. These include assessing readiness for participation in ACP and personalising relevance of ACP to each individual, routinely offering scheduled family meetings for exploring a person's own goals and sharing information, ensuring systems and policies are in place to access previous ACP documentation and ensuring doctors' education includes ACP communication skills.

Authors+Show Affiliations

Division of Palliative Medicine, Department of Oncology and Department of Internal Medicine, University of Calgary, Alberta, Canada.School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada.Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.Clinical Evaluation Research Unit, Department of Medicine, Kingston General Hospital, Kingston, Ontario, Canada Departments of Community Health and Epidemiology and Medicine, Queens University, Kingston, Ontario, Canada.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24644192

Citation

Simon, Jessica, et al. "'Not Yet' and 'Just Ask': Barriers and Facilitators to Advance Care Planning--a Qualitative Descriptive Study of the Perspectives of Seriously Ill, Older Patients and Their Families." BMJ Supportive & Palliative Care, vol. 5, no. 1, 2015, pp. 54-62.
Simon J, Porterfield P, Bouchal SR, et al. 'Not yet' and 'Just ask': barriers and facilitators to advance care planning--a qualitative descriptive study of the perspectives of seriously ill, older patients and their families. BMJ Support Palliat Care. 2015;5(1):54-62.
Simon, J., Porterfield, P., Bouchal, S. R., & Heyland, D. (2015). 'Not yet' and 'Just ask': barriers and facilitators to advance care planning--a qualitative descriptive study of the perspectives of seriously ill, older patients and their families. BMJ Supportive & Palliative Care, 5(1), 54-62. https://doi.org/10.1136/bmjspcare-2013-000487
Simon J, et al. 'Not Yet' and 'Just Ask': Barriers and Facilitators to Advance Care Planning--a Qualitative Descriptive Study of the Perspectives of Seriously Ill, Older Patients and Their Families. BMJ Support Palliat Care. 2015;5(1):54-62. PubMed PMID: 24644192.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 'Not yet' and 'Just ask': barriers and facilitators to advance care planning--a qualitative descriptive study of the perspectives of seriously ill, older patients and their families. AU - Simon,Jessica, AU - Porterfield,Pat, AU - Bouchal,Shelley Raffin, AU - Heyland,Daren, Y1 - 2013/11/19/ PY - 2014/3/20/entrez PY - 2014/3/20/pubmed PY - 2015/12/17/medline KW - Advance Care Planning KW - Communication KW - Critical Illness KW - Goals Of Care KW - Qualitative Research SP - 54 EP - 62 JF - BMJ supportive & palliative care JO - BMJ Support Palliat Care VL - 5 IS - 1 N2 - OBJECTIVES: To explore seriously ill, older hospitalised patients' and their family members' perspectives on the barriers and facilitators of advance care planning (ACP). METHODS: We used qualitative descriptive study methodology to analyse data from an interviewer administered, questionnaire-based, Canadian multicentre, prospective study of this population. RESULTS: Three main categories described these barriers and facilitators: (1) person (beliefs, attitudes, experiences, health status), (2) access (to doctors and healthcare providers, information, tools and infrastructure to communicate ACP preferences) and (3) the interaction with the doctor (who and how initiated, location, timing, quality of communication, relationship with doctor). CONCLUSIONS: Based on the findings, we suggest strategies for both healthcare systems and individual healthcare providers to improve the quality and quantity of ACP with this population. These include assessing readiness for participation in ACP and personalising relevance of ACP to each individual, routinely offering scheduled family meetings for exploring a person's own goals and sharing information, ensuring systems and policies are in place to access previous ACP documentation and ensuring doctors' education includes ACP communication skills. SN - 2045-4368 UR - https://www.unboundmedicine.com/medline/citation/24644192/'Not_yet'_and_'Just_ask':_barriers_and_facilitators_to_advance_care_planning__a_qualitative_descriptive_study_of_the_perspectives_of_seriously_ill_older_patients_and_their_families_ L2 - http://spcare.bmj.com/cgi/pmidlookup?view=long&pmid=24644192 DB - PRIME DP - Unbound Medicine ER -