Uptake of advance care planning and its circumstances: An nationwide survey in Australian general practice

2021 ◽  
Author(s):  
Jinfeng Ding ◽  
Angus Cook ◽  
Christobel Saunders ◽  
David Chua ◽  
Sharon Licqurish ◽  
...  
Keyword(s):  
General Practice ◽  
Advance Care Planning ◽  
Nationwide Survey ◽  
Care Planning ◽  
Australian General Practice ◽  
Advance Care

Association between religious beliefs and discussions regarding advance care planning: A nationwide survey

2021 ◽  
pp. 026921632110295
Author(s):  
Jun Miyashita ◽  
Sayaka Shimizu ◽  
Shunichi Fukuhara ◽  
Yosuke Yamamoto
Keyword(s):  
Health Care Providers ◽  
Advance Care Planning ◽  
Religious Beliefs ◽  
Nationwide Survey ◽  
Care Planning ◽  
Care Providers ◽  
Logistic Regression Models ◽  
Japanese Buddhism ◽  
Advance Care ◽  
Quota Sampling

Background: The relationship between advance care planning and religious beliefs, which are important for palliative care, is controversial in Western countries and has not been verified in Asian countries. Aim: To investigate the association between advance care planning discussions and religious beliefs in Japan. Design: A nationwide survey conducted in 2016 using a quota sampling method to obtain a representative sample of Japan’s general population. Setting/participants: We analyzed responses from 3167 adults aged 20–84 years (mean age ± standard deviation, 50.9 ± 16.8 years). The outcome was measured by asking whether the respondents had ever discussed advance care planning, and the main exposure by whether they had any religious beliefs or affiliations, and if so, their degree of devoutness. We analyzed religious beliefs, affiliations, and devoutness in relation to the occurrence of discussions using multivariable logistic regression models adjusted for possible sociodemographic covariates. Results: Compared with respondents without, those with religious beliefs had significantly higher odds of having had discussions (adjusted odds ratio: 1.45, 95% confidence interval: 1.22–1.73). The devoutness of religious belief was proportional to the propensity of the occurrence of discussions ( p for trend < 0.001). In addition, Buddhists and Christians had higher odds of having had discussions than did nonbelievers. Conclusion: The results suggest that holding religious beliefs, especially in Japanese Buddhism and Christianity, facilitates advance care planning discussions among Japanese adults, and thus, may help health-care providers identify those prioritized for facilitating engagement in advance care planning, especially in palliative and spiritual care settings.

scholarly journals Incorporating an advance care planning screening tool into routine health assessments with older people

2020 ◽  
Vol 26 (3) ◽  
pp. 240
Author(s):  
Abigail E. Franklin ◽  
Joel Rhee ◽  
Bronwyn Raymond ◽  
Josephine M. Clayton
Keyword(s):  
General Practice ◽  
Advance Care Planning ◽  
Screening Tool ◽  
Care Planning ◽  
Practice Nurses ◽  
Substitute Decision Maker ◽  
Health Assessments ◽  
Advance Care ◽  
Screening Interview

General practice is arguably the ideal setting to initiate advance care planning (ACP), but there are many barriers. This pilot study was designed to assess the feasibility, acceptability and perceived utility of a nurse-facilitated screening interview to initiate ACP with older patients in general practice. Patients were recruited from four general practices in Sydney, Australia. General practice nurses administered the ACP screening interview during routine health assessments. Patients and nurses completed a follow-up questionnaire consisting of questions with Likert responses, as well as open-ended questions. Descriptive statistics and content analysis were used to analyse the data. Twenty-four patients participated; 17 completed the follow-up questionnaire. All patients found the ACP screening interview useful and most felt it would encourage them to discuss their wishes further with their family and general practitioner. Several patients were prompted to consider legally appointing their preferred substitute decision-maker. All six participating nurses found the screening interview tool useful for initiating discussions about ACP and substitute decision-making. This nurse facilitated screening tool provides a simple, acceptable and feasible approach to introducing ACP to older general practice patients during routine health assessments.

scholarly journals Practice and Perceived Importance of Advance Care Planning and Difficulties in Providing Palliative Care in Geriatric Health Service Facilities in Japan: A Nationwide Survey

2017 ◽  
Vol 35 (3) ◽  
pp. 464-472 ◽  
Author(s):  
Shoji Yokoya ◽  
Yoshiyuki Kizawa ◽  
Takami Maeno
Keyword(s):  
Palliative Care ◽  
Health Service ◽  
Advance Care Planning ◽  
Nationwide Survey ◽  
Self Report ◽  
Care Planning ◽  
Care Education ◽  
Perceived Importance ◽  
Advance Care ◽  
Eol Care

Background: The provision of end-of-life (EOL) care by geriatric health service facilities (GHSFs) in Japan is increasing. Advance care planning (ACP) is one of the most important issues to provide quality EOL care. This study aimed to clarify the practice and perceived importance of ACP and the difficulties in providing palliative care in GHSFs. Methods: A self-report questionnaire was mailed to head nurses at 3437 GHSFs nationwide. We asked participants about their practices regarding ACP, their recognition of its importance, and their difficulties in providing palliative care. We also analyzed the relationship between these factors and EOL care education. Results: Among 844 respondents (24.5% response rate), approximately 69% to 81% of head nurses confirmed that GHSF residents and their families understood disease conditions and goals of care. There was a large discrepancy between the actual practice of ACP components and the recognition of their importance (eg, asking residents about existing advance directive [AD; 27.5% practiced it, while 79.6% considered it important]; recommending completion of an AD [18.1% vs 68.4%], and asking for designation of a health-care proxy [30.4% vs 76.8%]). The EOL care education was provided at 517 facilities (61.3%). Head nurses working at EOL care education–providing GHSFs practiced ACP significantly more frequently and had significantly fewer difficulties in providing palliative care. Conclusion: A large discrepancy was found between GHSF nurses’ practice of ACP and their recognition of its importance. Providing EOL care education in GHSFs may increase ACP practices and enhance respect for resident’s preferences concerning EOL care.

scholarly journals Advance Care Planning and Dying in Nursing Homes in Flanders, Belgium: A Nationwide Survey

2013 ◽  
Vol 45 (2) ◽  
pp. 223-234 ◽  
Author(s):  
Cindy De Gendt ◽  
Johan Bilsen ◽  
Robert Vander Stichele ◽  
Luc Deliens
Keyword(s):  
Nursing Homes ◽  
Advance Care Planning ◽  
Nationwide Survey ◽  
Care Planning ◽  
Advance Care

scholarly journals Advance Care Planning in Primary Care. A Retrospective Medical Record Study Among Patients With Different Illness Trajectories.

2021 ◽  
Author(s):  
Yvonne A.C. Bekker ◽  
A. Suntjens ◽  
Y. Engels ◽  
H. Schers ◽  
Gert P. Westert ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Organ Failure ◽  
Medical Record ◽  
Advance Care Planning ◽  
Medical Records ◽  
Daily Practice ◽  
Care Planning ◽  
Patients With Cancer ◽  
Advance Care

Abstract BackgroundAdvance Care Planning (ACP) enables physicians to align healthcare with patients wishes, reduces burdensome life-prolonging medical interventions, and potentially improves the quality of life of patients in the last phase of life. However, little objective information is available about the extent to which structured ACP conversations are held in general practice. Our aim was to examine the documentation of ACP for patients with cancer, organ failure and multimorbidity in medical records (as a proxy for ACP application) in Dutch general practice. MethodsWe chose a retrospective medical record study design in seven primary care facilities. Medical records of 119 patients who died non-suddenly (55 cancer, 28 organ failure and 36 multimorbidity) were analysed. Other variables were: general characteristics, data on ACP documentation, correspondence between medical specialist and GP, and healthcare utilization in the last two years of life. ResultsIn 65% of the records, one or more ACP items was registered. Most often documented were aspects regarding euthanasia (35%), the preferred place of care and death (29%) and concerns and hopes towards the future (29%). Median timing of the first ACP conversation was 126 days before death. ACP was more often documented in patients with cancer (84%) than in those with organ failure (57%) or multimorbidity (42%) (p = 0,000). Patients with cancer had the most frequent (median 3 times, inter-quartile range (IQR) 2-5), and extensive (median 5 items, IQR 2-7) ACP consultations. ConclusionDocumentation of ACP items in medical records by GPs is present, but incomplete, especially in patients with multimorbidity or organ failure. We recommend more attention for, and documentation of ACP in daily practice in order to start anticipatory conversations in time, and to address the needs of all people living with advanced conditions in primary care.

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