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How do Dutch primary care providers overcome barriers to advance care planning with older people? A qualitative study.
Fam Pract. 2019 03 20; 36(2):219-224.FP

Abstract

BACKGROUND

Few older people benefit from advance care planning (ACP), due to several barriers related to primary care professionals, such as insufficient knowledge, negative beliefs and a lack of time. Information on overcoming these barriers is limited. We assumed primary care professionals experienced in ACP with older patients are likely to have learned how to overcome these barriers.

OBJECTIVE

To investigate how Dutch primary care professionals experienced in ACP with older patients overcome these barriers.

METHODS

A qualitative study, based on semi-structured interviews, among a purposive sample of 14 Dutch primary care professionals experienced in ACP with older people. Transcripts were thematically analysed.

RESULTS

We interviewed eight general practitioners (GPs), three nurses and three elderly care physicians, experienced in ACP with older people. Respondents overcame their own insufficient knowledge and skills, as well as their negative attitudes and beliefs by gaining experience through practicing ACP in their daily practices, exchanging and reflecting on those experiences with peers, pursuing continuing education, teaching and participating in research. To overcome patients' and families' lack of initiative and openness to ACP, respondents prepared them for further steps in ACP. To overcome a lack of time, respondents used tools and information communication technology, delegated parts of ACP to other primary care professionals, acquired financing and systematized documentation of ACP.

CONCLUSION

Primary care professionals can overcome barriers to ACP with older patients by practicing, reflecting on experiences and pursuing continuing education, by preparing patients and involving family and by investing in support to approach ACP more efficiently.

Authors+Show Affiliations

Section of Medical Ethics, Department of General Practice, Academic Medical Centre, University of Amsterdam, the Netherlands.Section of Medical Ethics, Department of General Practice, Academic Medical Centre, University of Amsterdam, the Netherlands.Department of public and occupational health, Amsterdam Public Health Research Institute Expertise Centre for Palliative Care, VU Medical Centre, the Netherlands.Department of General Practice, Academic Medical Centre, University of Amsterdam, the Netherlands.Section of Medical Ethics, Department of General Practice, Academic Medical Centre, University of Amsterdam, the Netherlands.

Pub Type(s)

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

Language

eng

PubMed ID

29893922

Citation

Glaudemans, Jolien J., et al. "How Do Dutch Primary Care Providers Overcome Barriers to Advance Care Planning With Older People? a Qualitative Study." Family Practice, vol. 36, no. 2, 2019, pp. 219-224.
Glaudemans JJ, de Jong AE, Onwuteaka Philipsen BD, et al. How do Dutch primary care providers overcome barriers to advance care planning with older people? A qualitative study. Fam Pract. 2019;36(2):219-224.
Glaudemans, J. J., de Jong, A. E., Onwuteaka Philipsen, B. D., Wind, J., & Willems, D. L. (2019). How do Dutch primary care providers overcome barriers to advance care planning with older people? A qualitative study. Family Practice, 36(2), 219-224. https://doi.org/10.1093/fampra/cmy055
Glaudemans JJ, et al. How Do Dutch Primary Care Providers Overcome Barriers to Advance Care Planning With Older People? a Qualitative Study. Fam Pract. 2019 03 20;36(2):219-224. PubMed PMID: 29893922.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - How do Dutch primary care providers overcome barriers to advance care planning with older people? A qualitative study. AU - Glaudemans,Jolien J, AU - de Jong,Anja E, AU - Onwuteaka Philipsen,Bregje D, AU - Wind,Jan, AU - Willems,Dick L, PY - 2018/6/13/pubmed PY - 2019/7/30/medline PY - 2018/6/13/entrez KW - Advance care planning KW - aged KW - aged 80 and over KW - elderly care physicians KW - general practitioners KW - nurses SP - 219 EP - 224 JF - Family practice JO - Fam Pract VL - 36 IS - 2 N2 - BACKGROUND: Few older people benefit from advance care planning (ACP), due to several barriers related to primary care professionals, such as insufficient knowledge, negative beliefs and a lack of time. Information on overcoming these barriers is limited. We assumed primary care professionals experienced in ACP with older patients are likely to have learned how to overcome these barriers. OBJECTIVE: To investigate how Dutch primary care professionals experienced in ACP with older patients overcome these barriers. METHODS: A qualitative study, based on semi-structured interviews, among a purposive sample of 14 Dutch primary care professionals experienced in ACP with older people. Transcripts were thematically analysed. RESULTS: We interviewed eight general practitioners (GPs), three nurses and three elderly care physicians, experienced in ACP with older people. Respondents overcame their own insufficient knowledge and skills, as well as their negative attitudes and beliefs by gaining experience through practicing ACP in their daily practices, exchanging and reflecting on those experiences with peers, pursuing continuing education, teaching and participating in research. To overcome patients' and families' lack of initiative and openness to ACP, respondents prepared them for further steps in ACP. To overcome a lack of time, respondents used tools and information communication technology, delegated parts of ACP to other primary care professionals, acquired financing and systematized documentation of ACP. CONCLUSION: Primary care professionals can overcome barriers to ACP with older patients by practicing, reflecting on experiences and pursuing continuing education, by preparing patients and involving family and by investing in support to approach ACP more efficiently. SN - 1460-2229 UR - https://www.unboundmedicine.com/medline/citation/29893922/How_do_Dutch_primary_care_providers_overcome_barriers_to_advance_care_planning_with_older_people_A_qualitative_study_ L2 - https://academic.oup.com/fampra/article-lookup/doi/10.1093/fampra/cmy055 DB - PRIME DP - Unbound Medicine ER -