Improving person-centered advance care planning conversation with older people: a qualitative study of core components perceived by healthcare professionals

  • Muraya Tsukasa
    Faculty of Design, Kyushu University, Japan
  • Akagawa Yuko
    Department of Clinical Nursing, Akita University Graduate School of Health Science, Japan
  • Andoh Hideaki
    Department of Clinical Nursing, Akita University Graduate School of Health Science, Japan
  • Chiang Chifa
    Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Japan
  • Hirakawa Yoshihisa
    Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Japan

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Abstract

<p>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.</p><p>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.</p><p>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.</p><p>Conclusion: The results provide guidelines for the future development of novel, value-based, person-centered ACP practice for multidisciplinary healthcare professionals.</p>

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