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Palliative care health professionals' experiences of caring for patients with advance care directives.
Aust Health Rev. 2015 Apr; 39(2):154-159.AH

Abstract

OBJECTIVE

To explore the health professionals' (HPs) perceptions and experiences of advance care directives (ACDs) and advance care planning in Australian palliative care services.

METHODS

A nationwide survey of 105 palliative care services was conducted, with two HPs from each service invited to participate. A qualitative analysis of open responses about advance care planning was undertaken.

RESULTS

Sixty questionnaires were returned with open responses. Most responders were nurses (75%), aged ≥40 years (80%) and with a mean of 12 years palliative care experience. Data were grouped into four key themes: (1) the ACD; (2) the process of developing ACDs; (3) the process of using ACDs; and (4) the consequences of having ACDs. Participants were positive about advance care planning, commenting that ongoing communication about end-of-life care ensures mutual understanding between patients, family and HPs. Provision of care was considered easier and more efficient with an ACD in place. ACDs were perceived to reduce distrust and conflict between family, friends and HPs, and promote communication. Suboptimal documentation, clarity and explicitness limited the usefulness of ACDs when they were available.

CONCLUSIONS

Advance care planning benefits HPs, patients and their family. To maximise these benefits, ACDs need to be clear, comprehensive, medically relevant and transportable documents.

Authors+Show Affiliations

Cancer and Palliative Care Research and Evaluation Unit, School of Surgery, The University of Western Australia, M507, 35 Stirling Hwy, Crawley, WA 6009, Australia.Cancer and Palliative Care Research and Evaluation Unit, School of Surgery, The University of Western Australia, M507, 35 Stirling Hwy, Crawley, WA 6009, Australia.Palliative Care Outcomes Collaboration, Australian Health Services Research Institute, University of Wollongong, iC Enterprise 1, Innovation Campus, University of Wollongong, Wollongong, NSW 2522, Australia. Email.Respecting Patient Choices Program, Austin Hospital, PO Box 5555, Heidelberg, Vic. 3084, Australia. Email:.Respecting Patient Choices Program, Austin Hospital, PO Box 5555, Heidelberg, Vic. 3084, Australia. Email:.

Pub Type(s)

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

Language

eng

PubMed ID

25607507

Citation

Johnson, Claire E., et al. "Palliative Care Health Professionals' Experiences of Caring for Patients With Advance Care Directives." Australian Health Review : a Publication of the Australian Hospital Association, vol. 39, no. 2, 2015, pp. 154-159.
Johnson CE, Singer R, Masso M, et al. Palliative care health professionals' experiences of caring for patients with advance care directives. Aust Health Rev. 2015;39(2):154-159.
Johnson, C. E., Singer, R., Masso, M., Sellars, M., & Silvester, W. (2015). Palliative care health professionals' experiences of caring for patients with advance care directives. Australian Health Review : a Publication of the Australian Hospital Association, 39(2), 154-159. https://doi.org/10.1071/AH14119
Johnson CE, et al. Palliative Care Health Professionals' Experiences of Caring for Patients With Advance Care Directives. Aust Health Rev. 2015;39(2):154-159. PubMed PMID: 25607507.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Palliative care health professionals' experiences of caring for patients with advance care directives. AU - Johnson,Claire E, AU - Singer,Rachel, AU - Masso,Malcolm, AU - Sellars,Marcus, AU - Silvester,William, PY - 2014/07/23/received PY - 2014/11/10/accepted PY - 2015/1/22/entrez PY - 2015/1/22/pubmed PY - 2015/7/25/medline SP - 154 EP - 159 JF - Australian health review : a publication of the Australian Hospital Association JO - Aust Health Rev VL - 39 IS - 2 N2 - OBJECTIVE: To explore the health professionals' (HPs) perceptions and experiences of advance care directives (ACDs) and advance care planning in Australian palliative care services. METHODS: A nationwide survey of 105 palliative care services was conducted, with two HPs from each service invited to participate. A qualitative analysis of open responses about advance care planning was undertaken. RESULTS: Sixty questionnaires were returned with open responses. Most responders were nurses (75%), aged ≥40 years (80%) and with a mean of 12 years palliative care experience. Data were grouped into four key themes: (1) the ACD; (2) the process of developing ACDs; (3) the process of using ACDs; and (4) the consequences of having ACDs. Participants were positive about advance care planning, commenting that ongoing communication about end-of-life care ensures mutual understanding between patients, family and HPs. Provision of care was considered easier and more efficient with an ACD in place. ACDs were perceived to reduce distrust and conflict between family, friends and HPs, and promote communication. Suboptimal documentation, clarity and explicitness limited the usefulness of ACDs when they were available. CONCLUSIONS: Advance care planning benefits HPs, patients and their family. To maximise these benefits, ACDs need to be clear, comprehensive, medically relevant and transportable documents. SN - 0156-5788 UR - https://www.unboundmedicine.com/medline/citation/25607507/Palliative_care_health_professionals'_experiences_of_caring_for_patients_with_advance_care_directives_ L2 - http://www.publish.csiro.au/journals/abstractHTML.cfm?J=AH&F=AH14119abs.XML DB - PRIME DP - Unbound Medicine ER -