Anna Ugalde1, Clare O'Callaghan2,3,4, Clem Byard5, Samantha Brean6, Jenelle MacKay6, Anna Boltong5,7, Sondra Davoren5, Deborah Lawson5, Phillip Parente8, Natasha Michael2,9, Patricia Livingston10. 1. Faculty of Health, School of Nursing & Midwifery, Deakin University, 1 Gheringhap St, Geelong, VIC, Australia. a.ugalde@deakin.edu.au. 2. Palliative and Supportive Care Research Department, Cabrini Health, Malvern, VIC, Australia. 3. Institute for Ethics and Society, The University of Notre Dame, Sydney, Australia. 4. Departments of Psychosocial Cancer Care and Medicine, St Vincent's Hospital, The University of Melbourne, Fitzroy, VIC, Australia. 5. Cancer Council Victoria, Melbourne, VIC, Australia. 6. Eastern Health, Wantirna, VIC, Australia. 7. Melbourne School of Health Sciences, University of Melbourne, Parkville, Australia. 8. Eastern Health, Monash University, Box Hill, VIC, Australia. 9. Sydney School of Medicine, University of Notre Dame, Sydney, Australia. 10. Faculty of Health, School of Nursing & Midwifery, Deakin University, 1 Gheringhap St, Geelong, VIC, Australia.
Abstract
PURPOSE: While advance care planning holds promise, uptake is variable and it is unclear how well people engage with or comprehend advance care planning. The objective of this study was to explore how people with cancer comprehended advance care plans and examine how accurately advance care planning documentation represented patient wishes. METHODS: This study used a qualitative descriptive design. Data collection comprised interviews and an examination of participants' existing advance care planning documentation. Participants included those who had any diagnosis of cancer with an advance care plan recorded: Refusal of Treatment Certificate, Statement of Choices, and/or Enduring Power of Attorney (Medical Treatment) at one cancer treatment centre. RESULTS: Fourteen participants were involved in the study. Twelve participants were female (86%). The mean age was 77 (range: 61-91), and participants had completed their advance care planning documentation between 8 and 72 weeks prior to the interview (mean 33 weeks). Three themes were evident from the data: incomplete advance care planning understanding and confidence, limited congruence for attitude and documentation, advance care planning can enable peace of mind. Complete advance care planning understanding was unusual; most participants demonstrated partial comprehension of their own advance care plan, and some indicated very limited understanding. Participants' attitudes and their written document congruence were limited, but advance care planning was seen as helpful. CONCLUSIONS: This study highlighted advance care planning was not a completely accurate representation of patient wishes. There is opportunity to improve how patients comprehend their own advance care planning documentation.
PURPOSE: While advance care planning holds promise, uptake is variable and it is unclear how well people engage with or comprehend advance care planning. The objective of this study was to explore how people with cancer comprehended advance care plans and examine how accurately advance care planning documentation represented patient wishes. METHODS: This study used a qualitative descriptive design. Data collection comprised interviews and an examination of participants' existing advance care planning documentation. Participants included those who had any diagnosis of cancer with an advance care plan recorded: Refusal of Treatment Certificate, Statement of Choices, and/or Enduring Power of Attorney (Medical Treatment) at one cancer treatment centre. RESULTS: Fourteen participants were involved in the study. Twelve participants were female (86%). The mean age was 77 (range: 61-91), and participants had completed their advance care planning documentation between 8 and 72 weeks prior to the interview (mean 33 weeks). Three themes were evident from the data: incomplete advance care planning understanding and confidence, limited congruence for attitude and documentation, advance care planning can enable peace of mind. Complete advance care planning understanding was unusual; most participants demonstrated partial comprehension of their own advance care plan, and some indicated very limited understanding. Participants' attitudes and their written document congruence were limited, but advance care planning was seen as helpful. CONCLUSIONS: This study highlighted advance care planning was not a completely accurate representation of patient wishes. There is opportunity to improve how patients comprehend their own advance care planning documentation.
Entities:
Keywords:
Advance care planning; Advance directives; End-of-life; Medical treatments; Preferences; Refusal of treatment certificate; Statement of choices; Wishes
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