Patients' Experiences With Advance Care Planning and Decision-Making: An Interview Study in Finnish Hospital Palliative Care Wards.
Anne Kuusisto, Kaija Saranto, Katriina Lähteenmäki and 2 others
PMID 39963004WHAT IT FOUND
Palliative patients wanted discussions about care goals, clear symptom plans, and safe discharge with home support, equipment, and a known contact channel.
They described gaps in nursing documentation and follow-up that made care feel uncertain.
Key findings
01Patients wanted discussions about care goals and follow-up care, and many described unclear or missing care plans.
02Patients described nurses as important sources for information about pain and epilepsy medication, but some felt nursing staff did not always read care plans before giving care.
03Safe discharge meant arranging home support, assistive devices, family involvement, and a known contact channel; some patients had unpleasant experiences returning through the emergency department when continuity broke.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study reports patients' experiences and preferences, not whether any intervention worked. Only 20 Finnish-speaking cancer patients in hospital palliative wards were interviewed, so findings may not apply to hospice care, home care, other countries, or non-cancer palliative patients. Patients who were too unwell, confused, or anxious were excluded, so it may miss the experiences of people least able to speak. All participants had cancer, even though the inclusion criteria did not require cancer, limiting generalisability to other palliative diagnoses. No transcripts were returned to participants for comment, and one researcher led the analysis, so interpretation may be narrow. The researchers had palliative care experience, which they noted could influence interpretation.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read these themes as proof that care planning or nurse-led discussions improve palliative outcomes. This study describes 20 patients' experiences and preferences, not treatment effects.