Using Collective Intelligence to Develop Design Requirements for a Complex Intervention for Advance Care Planning in the Community.
Monika Pilch, Catherine B Hayes, Owen Harney and 4 others
PMID 39603997WHAT IT FOUND
Community dwellers, families and professionals named 109 barriers to advance care planning in Ireland, including fear, low awareness, unclear processes, family conflict and lack of time or tools.
These are design requirements, not tested care changes.
Key findings
01Twenty-two participants identified 109 barriers to advance care planning for community dwellers aged 50 years or older in Ireland.
02The largest barrier categories were psychological barriers (31 statements, 28.4%), resources and supports (20, 18.3%), and ACP processes and methods (19, 17.4%).
03Participants generated 222 options to address barriers and specified 230 service user needs, including communication, awareness, behavioural support, personal and interpersonal, and decision support needs.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study did not test whether any proposed option improves advance care planning or patient outcomes. Only 22 of 40 invited people took part, and participants were selected for lived experience or professional knowledge. Only 5 participants were patient, family or carer stakeholders. The sessions were held online because of COVID-19 restrictions, and fixed session times may have excluded some stakeholders. Patient, family and carer views were collected in a separate session, so direct interaction with other stakeholders was limited. The findings are specific to Ireland and may not apply to other health systems or cultures.
The easy way to misread this
Do not read the barriers, options and needs as evidence that an advance care planning intervention works. The study asked stakeholders to design requirements. It did not test any intervention or measure patient outcomes.