Douglas H Blackwood1, David Walker1, Monty G Mythen1,2, Rachel M Taylor3, Cecilia Vindrola-Padros4,5. 1. Centre for Perioperative Medicine, University College London (UCL), London, UK. 2. National Institute of Health Research Biomedical Research Centre, London, UK. 3. Centre for Nursing, Midwife and AHP Led Research (CNMR), University College London Hospitals NHS Foundation Trust, London, UK. 4. Department of Applied Health Research, University College London (UCL), London, UK. 5. NIAA Health Services Research Centre, Royal College of Anaesthetists, London, UK.
Abstract
INTRODUCTION: Advance care planning is a means for patients to communicate their wishes, fears and desires for future health decisions should they lose the ability to consider or communicate these. Despite being supported by governments and healthcare leaders, uptake amongst the general population remains low. Nurses play a crucial role in promoting and engaging with these discussions given their close relationship with patients and families in a range of clinical settings. AIM: To describe the barriers that nurses and healthcare professionals believe prevent them from exploring advance care planning with their patients. METHOD: We carried out a systematic review of peer-reviewed journal articles from the databases MEDLINE, Embase, CINAHL Plus, Web of Science and ProQuest Central, guided by the PRISMA checklist. RESULTS: Eleven articles were identified: all were self-reporting surveys using a mix of open and closed questions. They originated in the USA, Canada, Australia and Ireland. The participants included various healthcare professionals, with the majority of studies focussing on nurses. The two most important barriers to advance care planning are lack of education and insufficient time. Advance care planning appears to be well supported, and nurses and healthcare professionals report themselves to be comfortable and confident to take on the responsibility. CONCLUSION: There is a need for greater education and training for nurses and healthcare professionals. In particular, there needs to be better understanding of professional and legal responsibilities. The need for sufficient time to be made available to allow these conversations, in often busy settings, will need institutional and financial support. RELEVANCE TO CLINICAL PRACTICE: Increased training and knowledge are likely to lead to more positive attitudes and greater confidence for nurses, and other healthcare professionals, which should help support and encourage patient engagement with advance care planning.
INTRODUCTION: Advance care planning is a means for patients to communicate their wishes, fears and desires for future health decisions should they lose the ability to consider or communicate these. Despite being supported by governments and healthcare leaders, uptake amongst the general population remains low. Nurses play a crucial role in promoting and engaging with these discussions given their close relationship with patients and families in a range of clinical settings. AIM: To describe the barriers that nurses and healthcare professionals believe prevent them from exploring advance care planning with their patients. METHOD: We carried out a systematic review of peer-reviewed journal articles from the databases MEDLINE, Embase, CINAHL Plus, Web of Science and ProQuest Central, guided by the PRISMA checklist. RESULTS: Eleven articles were identified: all were self-reporting surveys using a mix of open and closed questions. They originated in the USA, Canada, Australia and Ireland. The participants included various healthcare professionals, with the majority of studies focussing on nurses. The two most important barriers to advance care planning are lack of education and insufficient time. Advance care planning appears to be well supported, and nurses and healthcare professionals report themselves to be comfortable and confident to take on the responsibility. CONCLUSION: There is a need for greater education and training for nurses and healthcare professionals. In particular, there needs to be better understanding of professional and legal responsibilities. The need for sufficient time to be made available to allow these conversations, in often busy settings, will need institutional and financial support. RELEVANCE TO CLINICAL PRACTICE: Increased training and knowledge are likely to lead to more positive attitudes and greater confidence for nurses, and other healthcare professionals, which should help support and encourage patient engagement with advance care planning.
Authors: Yi-Jhen He; Ming-Hwai Lin; Jo-Lan Hsu; Bo-Ren Cheng; Tzeng-Ji Chen; Shinn-Jang Hwang Journal: Int J Environ Res Public Health Date: 2021-01-07 Impact factor: 3.390
Authors: Hsueh-Hsing Pan; Li-Fen Wu; Li-Fang Chang; Yu-Chun Hung; Chin Lin; Ching-Liang Ho Journal: Int J Environ Res Public Health Date: 2021-01-30 Impact factor: 3.390
Authors: Georges Assaf; Sarah Jawhar; Kamal Wahab; Rita El Hachem; Tanjeev Kaur; Maria Tanielian; Lea Feghali; Adina Zeki Al Hazzouri; Martine Elbejjani Journal: BMJ Open Date: 2021-10-28 Impact factor: 3.006