Tags

Type your tag names separated by a space and hit enter

Preventing unwanted situations and gaining trust: a qualitative study of older people and families' experiences with advance care planning in the daily practice of primary care.
Fam Pract. 2020 Sep 05; 37(4):519-524.FP

Abstract

BACKGROUND

Using advance care planning (ACP) to anticipate future decisions can increase compliance with people's end-of-life wishes, decrease inappropriate life-sustaining treatment and reduce stress, anxiety and depression. Despite this, only a minority of older people engage in ACP, partly because care professionals lack knowledge of approaches towards ACP with older people and their families.

OBJECTIVE

To explore older people's and their families' experiences with ACP in primary care.

METHODS

We conducted qualitative, semi-structured, face-to-face interviews with 22 older people (aged >70 years, v/m: 11/11), with experience in ACP, and eight of their family members (aged 40-79 years, f/m: 7/1). Transcripts were inductively analysed using a grounded theory approach.

RESULTS

We distinguished three main themes. (i) Openness and trust: Respondents were more open to ACP if they wanted to prevent specific future situations and less open if they lacked trust or had negative thoughts regarding general practitioners' (GPs') time for and interest in ACP. Engaging in ACP appeared to increase trust. (ii) Timing and topics: ACP was not initiated too early. Quality of ACP seemed to improve if respondents' views on their current life and future, a few specific future care scenarios and expectations and responsibilities regarding ACP were discussed. (iii) Roles of family: Quality of ACP appeared to improve if family was involved in ACP.

CONCLUSIONS

Quality and accessibility of ACP may improve if GPs and nurses involve family, explain GPs' interest in ACP and discuss future situations older people may want to prevent, and views on their current life and future.

Authors+Show Affiliations

Section of Medical Ethics, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, the Netherlands.Section of Medical Ethics, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, the Netherlands.Department of General Practice, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, the Netherlands.Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, the Netherlands.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31816034

Citation

Glaudemans, Jolien J., et al. "Preventing Unwanted Situations and Gaining Trust: a Qualitative Study of Older People and Families' Experiences With Advance Care Planning in the Daily Practice of Primary Care." Family Practice, vol. 37, no. 4, 2020, pp. 519-524.
Glaudemans JJ, Willems DL, Wind J, et al. Preventing unwanted situations and gaining trust: a qualitative study of older people and families' experiences with advance care planning in the daily practice of primary care. Fam Pract. 2020;37(4):519-524.
Glaudemans, J. J., Willems, D. L., Wind, J., & Onwuteaka Philipsen, B. D. (2020). Preventing unwanted situations and gaining trust: a qualitative study of older people and families' experiences with advance care planning in the daily practice of primary care. Family Practice, 37(4), 519-524. https://doi.org/10.1093/fampra/cmz089
Glaudemans JJ, et al. Preventing Unwanted Situations and Gaining Trust: a Qualitative Study of Older People and Families' Experiences With Advance Care Planning in the Daily Practice of Primary Care. Fam Pract. 2020 Sep 5;37(4):519-524. PubMed PMID: 31816034.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preventing unwanted situations and gaining trust: a qualitative study of older people and families' experiences with advance care planning in the daily practice of primary care. AU - Glaudemans,Jolien J, AU - Willems,Dick L, AU - Wind,Jan, AU - Onwuteaka Philipsen,Bregje D, PY - 2019/12/10/pubmed PY - 2019/12/10/medline PY - 2019/12/10/entrez KW - Aging KW - caregivers KW - geriatrics KW - medical ethics KW - palliative care/end-of-life care KW - primary care SP - 519 EP - 524 JF - Family practice JO - Fam Pract VL - 37 IS - 4 N2 - BACKGROUND: Using advance care planning (ACP) to anticipate future decisions can increase compliance with people's end-of-life wishes, decrease inappropriate life-sustaining treatment and reduce stress, anxiety and depression. Despite this, only a minority of older people engage in ACP, partly because care professionals lack knowledge of approaches towards ACP with older people and their families. OBJECTIVE: To explore older people's and their families' experiences with ACP in primary care. METHODS: We conducted qualitative, semi-structured, face-to-face interviews with 22 older people (aged >70 years, v/m: 11/11), with experience in ACP, and eight of their family members (aged 40-79 years, f/m: 7/1). Transcripts were inductively analysed using a grounded theory approach. RESULTS: We distinguished three main themes. (i) Openness and trust: Respondents were more open to ACP if they wanted to prevent specific future situations and less open if they lacked trust or had negative thoughts regarding general practitioners' (GPs') time for and interest in ACP. Engaging in ACP appeared to increase trust. (ii) Timing and topics: ACP was not initiated too early. Quality of ACP seemed to improve if respondents' views on their current life and future, a few specific future care scenarios and expectations and responsibilities regarding ACP were discussed. (iii) Roles of family: Quality of ACP appeared to improve if family was involved in ACP. CONCLUSIONS: Quality and accessibility of ACP may improve if GPs and nurses involve family, explain GPs' interest in ACP and discuss future situations older people may want to prevent, and views on their current life and future. SN - 1460-2229 UR - https://www.unboundmedicine.com/medline/citation/31816034/Preventing_unwanted_situations_and_gaining_trust:_a_qualitative_study_of_older_people_and_families'_experiences_with_advance_care_planning_in_the_daily_practice_of_primary_care_ L2 - https://academic.oup.com/fampra/article-lookup/doi/10.1093/fampra/cmz089 DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.