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What makes advance care planning discussion so difficult? A systematic review of the factors of advance care planning in healthcare settings.
Suen, Margaret Hay Ping; Chow, Amy Yin Man; Woo, Raymond Kam Wing; Yuen, Sze Kit.
Afiliação
  • Suen MHP; Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong.
  • Chow AYM; Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong.
  • Woo RKW; Jockey Club End-of-Life Community Care Project, The University of Hong Kong, Hong Kong.
  • Yuen SK; Caritas Medical Centre, Hospital Authority, Hong Kong.
Palliat Support Care ; : 1-14, 2024 May 20.
Article em En | MEDLINE | ID: mdl-38766704
ABSTRACT

OBJECTIVES:

Existing systematic reviews related to advance care planning (ACP) largely focus on specific groups and intervention efficacy or are limited to contextual factors. This research aims to identify the modifiable factors perceived by different users of ACP in healthcare settings and inform healthcare professionals about the factors affecting ACP practice.

METHODS:

Five English-language databases (ProQuest, PubMed, CINAHL Plus, Scopus, and Medline) and two Chinese-language databases (CNKI and NCL) were searched up to November 2022. Empirical research identifying factors related to ACP in healthcare settings was included. ACP is defined as a discussion process on future end-of-life care. Thematic synthesis was performed on all included studies.

RESULTS:

A total of 1871 unique articles were screened; the full texts of 193 were assessed by 4 reviewers, and 45 articles were included for analysis. Twenty-two (54%) studies were qualitative, 15 (33%) were quantitative, and 6 (13%) used mixed methods. Foci varied from 28 (62%) studies on a single subject group (either patient, family, or physician), 11 (25%) on 2 subject groups (either patient and family or patient and healthcare professional), and 6 (13%) covered 3 subject groups (patient, family, and healthcare professional). Among the 17 studies involving more than 1 subject group, only 2 adopted a dyadic lens in analysis. Complex interwoven factors were categorized into (1) intrapersonal factors, (2) interpersonal factors, and (3) socio-environmental factors, with a total of 11 themes personal belief, emotions, the burden on others, timing, responsiveness, relationship, family dynamics, experience, person taking the lead, culture, and support. SIGNIFICANCE OF

RESULTS:

Patients, families, and healthcare professionals are the essential stakeholders of ACP in healthcare settings. Factors are interweaved among the intrapersonal, interpersonal, and socio-environmental dimensions. Research is warranted to examine the dynamic interactions of the 3 essential stakeholders from a multidimensional perspective, and the mechanism of the interweaving of factors.
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Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article