Advance Care Planning in palliative care: A systematic literature review of the contextual factors influencing its uptake 2008–2012

Background: Advance Care Planning is an iterative process of discussion, decision-making and documentation about end-of-life care. Advance Care Planning is highly relevant in palliative care due to intersecting clinical needs. To enhance the implementation of Advance Care Planning, the contextual fa...

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Vydáno v:Palliative medicine Ročník 28; číslo 8; s. 1026 - 1035
Hlavní autoři: Lovell, Allison, Yates, Patsy
Médium: Journal Article
Jazyk:angličtina
Vydáno: London, England SAGE Publications 01.09.2014
Sage Publications Ltd
Témata:
Advance Care Planning - legislation & jurisprudence
Advance Care Planning - statistics & numerical data
African Americans
Age Factors
Appraisal
Attitudes
Cancer
Care plans
Context
Decision making
Documentation
Educational Status
End of life decisions
Ethnicity - psychology
Functional impairment
Grammatical aspect
Health
Health care
Health Occupations - education
Health services
Higher education
Hospice care
Humans
Legal status
Legislatures
Literature reviews
Malignant
Medical diagnosis
Medical personnel
Medical prognosis
Neoplasms - psychology
Palliative Care
Patient Preference
Patients
Planning
Quality of care
Systematic review
Uncertainty
United States
Uptake
United States
Advance Care Planning
terminal care
palliative therapy
Living Wills
palliative care
Advance Directives
ISSN:0269-2163, 1477-030X, 1477-030X
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Shrnutí:Background: Advance Care Planning is an iterative process of discussion, decision-making and documentation about end-of-life care. Advance Care Planning is highly relevant in palliative care due to intersecting clinical needs. To enhance the implementation of Advance Care Planning, the contextual factors influencing its uptake need to be better understood. Aim: To identify the contextual factors influencing the uptake of Advance Care Planning in palliative care as published between January 2008 and December 2012. Methods: Databases were systematically searched for studies about Advance Care Planning in palliative care published between January 2008 and December 2012. This yielded 27 eligible studies, which were appraised using National Institute of Health and Care Excellence Quality Appraisal Checklists. Iterative thematic synthesis was used to group results. Results: Factors associated with greater uptake included older age, a college degree, a diagnosis of cancer, greater functional impairment, being white, greater understanding of poor prognosis and receiving or working in specialist palliative care. Barriers included having non-malignant diagnoses, having dependent children, being African American, and uncertainty about Advance Care Planning and its legal status. Individuals’ previous illness experiences, preferences and attitudes also influenced their participation. Conclusion: Factors influencing the uptake of Advance Care Planning in palliative care are complex and multifaceted reflecting the diverse and often competing needs of patients, health professionals, legislature and health systems. Large population-based studies of palliative care patients are required to develop the sound theoretical and empirical foundation needed to improve uptake of Advance Care Planning in this setting.
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ISSN:0269-2163
1477-030X
1477-030X
DOI:10.1177/0269216314531313