Cheng-Pei Lin1, Catherine J Evans1,2, Jonathan Koffman1, Ping-Jen Chen3,4, Ming-Feng Hou5, Richard Harding1. 1. Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK. 2. Sussex Community NHS Foundation Trust, Brighton, UK. 3. Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. 4. Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK. 5. Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Abstract
BACKGROUND: Increasing evidence shows that advance care planning is effective in improving outcomes. However, its applicability and acceptability outside Western cultures remain unknown. Examination of relevant cultural adaptations is required prior to wider adoption. AIM: To examine the feasibility and acceptability of a culturally adapted advance care planning intervention in a Taiwanese inpatient hospital for advanced cancer patients, family members and healthcare professionals. METHODS: A single-group, non-controlled, mixed methods feasibility study guided by a previously developed logic model. The culturally adapted advance care planning intervention represented a one-time intervention, comprising pre-advance care planning preparation and follow-up consultation. Qualitative interviews explored participants' view on their involvement in the study. Patients' medical records were examined to assess intervention fidelity. Findings from both data sets were integrated following analysis. RESULTS: N = 29 participants (n = 10 patients; n = 10 family members and n = 9 healthcare professionals) participated in the intervention, of who 28 completed follow-up interviews. Of the 10 advance care planning interventions delivered, most components (n = 10/13) were met. Key contextual moderators influencing the intervention feasibility included: (1) resource constraints resulting in increased workload; (2) care decisions informed by relatives' experiences of care; (3) the requirement for financial and policy support; and (4) a presumption for end-of-life care provision and surrogate decision-making. Six areas of intervention refinement were identified for future research. CONCLUSION: Implementing a culturally adapted advance care planning intervention in an inpatient hospital setting in Taiwan is possible. The participants reported the intervention to be acceptable. However, careful attention to the conceptual underpinning using local primary data is imperative for its success.
BACKGROUND: Increasing evidence shows that advance care planning is effective in improving outcomes. However, its applicability and acceptability outside Western cultures remain unknown. Examination of relevant cultural adaptations is required prior to wider adoption. AIM: To examine the feasibility and acceptability of a culturally adapted advance care planning intervention in a Taiwanese inpatient hospital for advanced cancerpatients, family members and healthcare professionals. METHODS: A single-group, non-controlled, mixed methods feasibility study guided by a previously developed logic model. The culturally adapted advance care planning intervention represented a one-time intervention, comprising pre-advance care planning preparation and follow-up consultation. Qualitative interviews explored participants' view on their involvement in the study. Patients' medical records were examined to assess intervention fidelity. Findings from both data sets were integrated following analysis. RESULTS: N = 29 participants (n = 10 patients; n = 10 family members and n = 9 healthcare professionals) participated in the intervention, of who 28 completed follow-up interviews. Of the 10 advance care planning interventions delivered, most components (n = 10/13) were met. Key contextual moderators influencing the intervention feasibility included: (1) resource constraints resulting in increased workload; (2) care decisions informed by relatives' experiences of care; (3) the requirement for financial and policy support; and (4) a presumption for end-of-life care provision and surrogate decision-making. Six areas of intervention refinement were identified for future research. CONCLUSION: Implementing a culturally adapted advance care planning intervention in an inpatient hospital setting in Taiwan is possible. The participants reported the intervention to be acceptable. However, careful attention to the conceptual underpinning using local primary data is imperative for its success.
Entities:
Keywords:
Advance care planning; cancer; cultural adaptation; feasibility and acceptability; palliative care
Authors: Cheng-Pei Lin; Jen-Kuei Peng; Ping-Jen Chen; Hsien-Liang Huang; Su-Hsuan Hsu; Shao-Yi Cheng Journal: Int J Environ Res Public Health Date: 2020-10-29 Impact factor: 3.390
Authors: Laura Cottrell; Guillaume Economos; Catherine Evans; Eli Silber; Rachel Burman; Richard Nicholas; Bobbie Farsides; Stephen Ashford; Jonathan Simon Koffman Journal: PLoS One Date: 2020-10-16 Impact factor: 3.240
Authors: Diah Martina; Olaf P Geerse; Cheng-Pei Lin; Martina S Kristanti; Wichor M Bramer; Masanori Mori; Ida J Korfage; Agnes van der Heide; Judith Ac Rietjens; Carin Cd van der Rijt Journal: Palliat Med Date: 2021-09-06 Impact factor: 4.762