Educational Resources and Self-Management Support to Engage Patients in Advance Care Planning: An Interpretation of Current Practice in the US.
Priscilla Gazarian, Avni Gupta, Amanda Reich and 9 others
PMID 35077259WHAT IT FOUND
Advance care planning resources were often used to fill out forms, not to help people discuss values and goals.
Reviewing materials outside visits and team follow-up were described as ways to support conversations with family.
Key findings
01179 of 274 stakeholder interviews referenced ACP resources, and 6 of 7 patient focus groups mentioned them, but many clinicians reported not using or not knowing about resources.
02Among 322 stakeholder resource references, preference documentation resources were mentioned 221 times and engagement resources 90 times; engagement resources were described as supporting communication, reflection on values, and decision making.
03Participants suggested giving patients time to review materials outside visits and using interprofessional staff, including nurses, social workers, chaplains, librarians, or volunteers, to support ACP resource use.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was mostly white and focus group participants were generally well educated, so findings may not transfer to more diverse or less resourced communities. Most participants were clinicians or patients already interested in or championing advance care planning, and many clinicians were from specialties where advance care planning is common. The paper reports both 37 and 34 patient focus group participants, so the exact patient sample size is unclear. Qualitative data describe views and practices, not whether resources improved advance care planning completion, communication, or patient outcomes. Findings depend on participants' ability to articulate experiences and on the specific health system context.
Declared interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
The easy way to misread this
Do not conclude that advance care planning resources were shown to improve care. This qualitative study reports participants' views, and many participants were clinicians or patients who already valued advance care planning, so it does not test whether the resources work.