RESUMO
Objective: The non-medical needs of patients, such as values and personal preferences, are likely to be omitted from advance care planning (ACP) discussions because of a lack of readiness and awareness on the part of healthcare professionals. The aim of the present study was to identify core components perceived by multidisciplinary healthcare professionals to improve person-centered ACP conversations with older people.Methods: The study participants were healthcare professionals (physicians, nurses, and care managers) working in different cities. This qualitative study was performed online using eight individual in-depth interviews and one subsequent focus group composed of eight healthcare professionals. The interviews and focus group discussion were audio-recorded online and transcribed verbatim. The aim of the analysis of the individual in-depth interviews was to summarize the transcribed results, create a conceptual framework for person-centered ACP conversation, and provide meaningful interpretations of the focus group participant discourse. The qualitative data were then analyzed by inductive manual coding using a qualitative content analysis approach.Results: Five themes capturing the core components for successful person-centered ACP were extracted from the ideas voiced by participants: Placing highest value on patient autonomy and human life; uncovering patient’s true feelings and desires; sharing collected information on patients’ end-of-life wishes with other team members; relaying patients’ wishes to the physician; and handling conflicts among patients, relatives, and healthcare professionals.Conclusion: The results provide guidelines for the future development of novel, value-based, person-centered ACP practice for multidisciplinary healthcare professionals.
RESUMO
Purpose: To clarify current status of nurses in support of children with parents with cancer in Akita Prefecture. Method: Questionnaire surveys were administered on nurses in Akita prefecture. Their experiences, educational backgrounds, and ability to recognize the need for support were examined. Descriptive statistics were used for the attributes, and chi-square test or Fisher’s exact Test or Wilcoxon rank sum test was used to examine the relationship between the support experience and the attributes (p<0.05). The contents of their open comments were then analyzed using a qualitative integration method. Results: Responses were obtained from 141 nurses at 10 facilities (collection rate: 43.9%). Of the 141 nurses, 135 (96%) recognized the necessity of support for children, and 28 (20%) already had experience supporting them. The contents of support were [direct support for children] [support for children through parents] [support through coordination and coordination with resources]. Most apparent difficulties in support were “Intervene for children” and “to have a connection with children”. Conclusion: The results indicate that nurses recognize that children need support. However, they lack experience in providing such support. It is necessary to enhance support by learning support methods and sharing information with other occupations. Support from parents is important when children cannot be met.