Birgit Vanderhaeghen1, Inge Bossuyt1, Johan Menten1,2, Peter Rober3,4. 1. Palliative Support Team, University Hospitals Leuven, Leuven, Belgium. 2. Department of Radiation-Oncology and Palliative Care, University Hospitals Leuven, Leuven, Belgium. 3. Context, University Psychiatric Centre and Katholieke Universiteit (KU) Leuven, Leuven, Belgium. 4. Department of Neurosciences, Institute for Family and Sexuality Studies, 26657KU Leuven Medical School, Leuven, Belgium.
Abstract
BACKGROUND: Advance care planning is not well implemented in Belgian hospital practice. In order to obtain successful implementation, implementation theory states that the adopters should be involved in the implementation process. This information can serve as a basis for creating better implementation strategies. AIM: For this study, we asked hospitalized palliative patients and their families what they experienced as good advance care planning. METHODS: Twenty-nine interviews were taken from patients and families, following the Tape Assisted Recall procedure of Elliot. These interviews were analyzed using content analysis based on grounded theory. To improve reliability, 3 independent external auditors audited the analysis. RESULTS: Results show that hospitalized palliative patients and families want to have advance care planning communication about treatment and care throughout their disease and about different aspects: social, psychological, physical, practical, and medical. They prefer to have these conversations with their supervising physician. They report 4 important goals of advance care planning communication: establishing a trustful relationship with the physician, in which they feel the involvement of the physician; giving and receiving relevant information for the decision process, making a personal decision about which treatment and care are preferred; and finding consensus between the preferred decision of the physician, the patient and the family concerning the treatment and care policy. CONCLUSION: This study can contribute to advance care planning implementation in hospital practice because it gives in insight into which elements in advance care planning patients and families experience as necessary and when advance care planning is necessary to them.
BACKGROUND: Advance care planning is not well implemented in Belgian hospital practice. In order to obtain successful implementation, implementation theory states that the adopters should be involved in the implementation process. This information can serve as a basis for creating better implementation strategies. AIM: For this study, we asked hospitalized palliative patients and their families what they experienced as good advance care planning. METHODS: Twenty-nine interviews were taken from patients and families, following the Tape Assisted Recall procedure of Elliot. These interviews were analyzed using content analysis based on grounded theory. To improve reliability, 3 independent external auditors audited the analysis. RESULTS: Results show that hospitalized palliative patients and families want to have advance care planning communication about treatment and care throughout their disease and about different aspects: social, psychological, physical, practical, and medical. They prefer to have these conversations with their supervising physician. They report 4 important goals of advance care planning communication: establishing a trustful relationship with the physician, in which they feel the involvement of the physician; giving and receiving relevant information for the decision process, making a personal decision about which treatment and care are preferred; and finding consensus between the preferred decision of the physician, the patient and the family concerning the treatment and care policy. CONCLUSION: This study can contribute to advance care planning implementation in hospital practice because it gives in insight into which elements in advance care planning patients and families experience as necessary and when advance care planning is necessary to them.
Entities:
Keywords:
advance care planning; family involvement; grounded theory; hospital care; patient-centered care; patient–caregiver communication; patient–physician communication
Authors: Anna Kowalczys; Michał Bohdan; Alina Wilkowska; Iga Pawłowska; Leszek Pawłowski; Piotr Janowiak; Ewa Jassem; Małgorzata Lelonek; Marcin Gruchała; Piotr Sobański Journal: Front Cardiovasc Med Date: 2022-09-27