Tags

Type your tag names separated by a space and hit enter

Current practices, barriers and enablers for advance care planning among healthcare workers of aged care facilities in western New South Wales, Australia.
Rural Remote Health. 2018 11; 18(4):4714.RR

Abstract

INTRODUCTION

Advance care planning (ACP) and advance care directives (ACDs) play a vital role in preparing for end-of-life care. However, current literature suggests that uptake of ACP and ACDs in rural Australia is low, which may contribute to lower quality care for the older rural population, as patients' end-of-life wishes may not be recognised and acknowledged. This study aims to provide a current perspective on the attitudes and practices of healthcare workers from residential aged care facilities towards ACP and ACDs in the central west, far west and Orana regions of New South Wales, Australia.

METHODS

This was a mixed-methods study incorporating anonymous survey and individual interviews. Healthcare workers from 12 residential aged care facilities within the studied region completed surveys (n=109). The 40-item survey assessed participant demographics, training and experience with ACP and ACD, attitudes towards ACP and ACDs, and barriers and facilitators towards the use of ACP and ACDs in their organisation. Five participants were interviewed to explore these issues in more depth.

RESULTS

Almost three-quarters (71%) of respondents thought that ACP is necessary while almost half (48%) were involved with >5 ACDs in the past 12 months. Formal training was seen as beneficial by most (81%) but the importance of practical experience was also acknowledged. No statistically significant differences were found in attitudes between those with 5 years of experience. Avoidance of unnecessary resuscitation was a consistent theme in all interviews and the potential of a nurse-led model of delivery was identified. Patient factors such as decreased capacity to make informed decisions were identified as barriers that could be circumvented by pre-emptive implementation of ACP discussion. The rural setting was identified as a facilitator due to a supportive community, which helped to mitigate barriers such as limited staffing.

CONCLUSIONS

Attitudes towards ACP in rural New South Wales are highly positive. The rural setting is a facilitator to ACP, and ACDs are approached in a multidisciplinary fashion. Further training is an identified need although on-the-ground experience may be more beneficial.

Authors+Show Affiliations

Bathurst Rural Clinical School, Western Sydney University, PO Box 9008, Bathurst, NSW 2795, Australia larrylam94@gmail.com.Bathurst Rural Clinical School, Western Sydney University, PO Box 9008, Bathurst, NSW 2795, Australia armaanshankaransari@gmail.com.Bathurst Rural Clinical School, Western Sydney University, PO Box 9008, Bathurst, NSW 2795, Australia patrick.baquir@gmail.com.Bathurst Rural Clinical School, Western Sydney University, PO Box 9008, Bathurst, NSW 2795, Australia nazzy.c77@gmail.com.Bathurst Rural Clinical School, Western Sydney University, PO Box 9008, Bathurst, NSW 2795, Australia kelvintran000@gmail.com.Bathurst Rural Clinical School, Western Sydney University, PO Box 9008, Bathurst, NSW 2795, Australia jannine.bailey@westernsydney.edu.au.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30447659

Citation

Lam, Larry, et al. "Current Practices, Barriers and Enablers for Advance Care Planning Among Healthcare Workers of Aged Care Facilities in Western New South Wales, Australia." Rural and Remote Health, vol. 18, no. 4, 2018, p. 4714.
Lam L, Ansari AS, Baquir PJ, et al. Current practices, barriers and enablers for advance care planning among healthcare workers of aged care facilities in western New South Wales, Australia. Rural Remote Health. 2018;18(4):4714.
Lam, L., Ansari, A. S., Baquir, P. J., Chowdhury, N., Tran, K., & Bailey, J. (2018). Current practices, barriers and enablers for advance care planning among healthcare workers of aged care facilities in western New South Wales, Australia. Rural and Remote Health, 18(4), 4714. https://doi.org/10.22605/RRH4714
Lam L, et al. Current Practices, Barriers and Enablers for Advance Care Planning Among Healthcare Workers of Aged Care Facilities in Western New South Wales, Australia. Rural Remote Health. 2018;18(4):4714. PubMed PMID: 30447659.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Current practices, barriers and enablers for advance care planning among healthcare workers of aged care facilities in western New South Wales, Australia. AU - Lam,Larry, AU - Ansari,Armaan S, AU - Baquir,Patrick J, AU - Chowdhury,Naziha, AU - Tran,Kelvin, AU - Bailey,Jannine, Y1 - 2018/11/19/ PY - 2018/11/19/entrez PY - 2018/11/19/pubmed PY - 2019/2/7/medline KW - Australia KW - advance care directives KW - community healthcare KW - end of life care KW - residential facilities KW - advance care planning SP - 4714 EP - 4714 JF - Rural and remote health JO - Rural Remote Health VL - 18 IS - 4 N2 - INTRODUCTION: Advance care planning (ACP) and advance care directives (ACDs) play a vital role in preparing for end-of-life care. However, current literature suggests that uptake of ACP and ACDs in rural Australia is low, which may contribute to lower quality care for the older rural population, as patients' end-of-life wishes may not be recognised and acknowledged. This study aims to provide a current perspective on the attitudes and practices of healthcare workers from residential aged care facilities towards ACP and ACDs in the central west, far west and Orana regions of New South Wales, Australia. METHODS: This was a mixed-methods study incorporating anonymous survey and individual interviews. Healthcare workers from 12 residential aged care facilities within the studied region completed surveys (n=109). The 40-item survey assessed participant demographics, training and experience with ACP and ACD, attitudes towards ACP and ACDs, and barriers and facilitators towards the use of ACP and ACDs in their organisation. Five participants were interviewed to explore these issues in more depth. RESULTS: Almost three-quarters (71%) of respondents thought that ACP is necessary while almost half (48%) were involved with >5 ACDs in the past 12 months. Formal training was seen as beneficial by most (81%) but the importance of practical experience was also acknowledged. No statistically significant differences were found in attitudes between those with 5 years of experience. Avoidance of unnecessary resuscitation was a consistent theme in all interviews and the potential of a nurse-led model of delivery was identified. Patient factors such as decreased capacity to make informed decisions were identified as barriers that could be circumvented by pre-emptive implementation of ACP discussion. The rural setting was identified as a facilitator due to a supportive community, which helped to mitigate barriers such as limited staffing. CONCLUSIONS: Attitudes towards ACP in rural New South Wales are highly positive. The rural setting is a facilitator to ACP, and ACDs are approached in a multidisciplinary fashion. Further training is an identified need although on-the-ground experience may be more beneficial. SN - 1445-6354 UR - https://www.unboundmedicine.com/medline/citation/30447659/Current_practices_barriers_and_enablers_for_advance_care_planning_among_healthcare_workers_of_aged_care_facilities_in_western_New_South_Wales_Australia_ L2 - http://www.rrh.org.au/articles/subviewnew.asp?ArticleID=4714 DB - PRIME DP - Unbound Medicine ER -