Does implementation matter if comprehension is lacking? A qualitative investigation into perceptions of advance care planning in people with cancer

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...

Full description

Saved in:
Bibliographic Details
Published in:Supportive care in cancer 2018-11, Vol.26 (11), p.3765-3771
Main Authors: Ugalde, Anna, O’Callaghan, Clare, Byard, Clem, Brean, Samantha, MacKay, Jenelle, Boltong, Anna, Davoren, Sondra, Lawson, Deborah, Parente, Phillip, Michael, Natasha, Livingston, Patricia
Format: Article
Language:English
Subjects:
Advance directives
Cancer
Data collection
Documentation
Investigations
Medical research
Medicine
Medicine & Public Health
Mental competency
Nursing
Nursing Research
Oncology
Original Article
Pain Medicine
Planning
Rehabilitation Medicine
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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.
ISSN:0941-4355
1433-7339
DOI:10.1007/s00520-018-4241-y