scholarly journals Facilators and Barriers to Advance Care Planning Engagement among Chronic Kidney Patients in Taiwan

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 777-777
Author(s):  
YuHsuan (Olivia) Wang ◽  
Susan Enguidanos
Keyword(s):  
Kidney Disease ◽  
End Of Life ◽  
Advance Care Planning ◽  
Critical Role ◽  
Care Team ◽  
Care Planning ◽  
Theory Approach ◽  
Structured Interviews ◽  
Advance Care

Abstract End-Stage Renal Disease (ESRD) patients experience high rates of cognitive impairment and lower quality of life at end of life. Having an advance care planning (ACP) conversation is associated with better care at end of life and improved care consistency with patient preferences. Taiwan ranks highest in ESRD and dialysis incidence worldwide, highlighting the importance of ACP among this population. Since 2019, the Patient Autonomy Act entitled Taiwanese to engage in ACP, but strategies to promote its uptake and the role of healthcare providers and caregivers in ACP conversations remains unclear. This study aimed to investigate facilitators and barriers to ACP engagment among Taiwanese with kidney disease and their caregivers. In 2020, we recruited 18 adults with stage 3—5 kidney disease and their caregivers. We conducted semi-structured interviews to elicit knowledges and perspectives on ACP. A grounded theory approach was used to guide the analysis of primary themes. Two researchers independently coded the transcripts and met to reconcile codes. The primary barrier to ACP was the misconception that it equated to funeral arrangements. Themes related to ACP facilitators included: trust in the nephrology care team (especially in case managers); straighforward communication; and in-person consultations. Additionally, transplant patients were more likely to have ACP discussions with their loved ones. While kidney disease patients preferred straightforward communication, caregivers preferred indirect communications. These findings emphasize the critical role of the nephrological care team members. Improving knowledge of ACP and facilitating communication between caregivers and kidney disease patients in Taiwan is needed.

Treatment preferences and advance care planning at end of life: The role of ethnicity and spiritual coping in cancer patients

2005 ◽  
Vol 30 (2) ◽  
pp. 174-179 ◽  
Author(s):  
Gala True ◽  
Etienne J. Phipps ◽  
Leonard E. Braitman ◽  
Tina Harralson ◽  
Diana Harris ◽  
...  
Keyword(s):  
End Of Life ◽  
Cancer Patients ◽  
Advance Care Planning ◽  
Spiritual Coping ◽  
Treatment Preferences ◽  
Care Planning ◽  
Advance Care

Readiness to participate in advance care planning: A qualitative study of renal failure patients, families and healthcare providers

2017 ◽  
Vol 13 (3) ◽  
pp. 171-187 ◽  
Author(s):  
Lauren A Hutchison ◽  
Donna S Raffin-Bouchal ◽  
Charlotte A Syme ◽  
Patricia D Biondo ◽  
Jessica E Simon
Keyword(s):  
Renal Failure ◽  
End Of Life ◽  
Advance Care Planning ◽  
Healthcare Providers ◽  
Care Planning ◽  
Structured Interviews ◽  
Individual Values ◽  
Advance Care ◽  
The Moment ◽  
End Of Life Decision

Objectives Advance care planning is the process by which people reflect upon their wishes and values for healthcare, discuss their choices with family and friends and document their wishes. Readiness represents a key predictor of advance care planning participation; however, the evidence for addressing readiness is scarce within the renal failure context. Our objectives were to assess readiness for advance care planning and barriers and facilitators to advance care planning uptake in a renal context. Methods Twenty-five participants (nine patients, nine clinicians and seven family members) were recruited from the Southern Alberta Renal Program. Semi-structured interviews were recorded, transcribed and then analyzed using interpretive description. Results Readiness for advance care planning was driven by individual values perceived by a collaborative encounter between clinicians and patients/families. If advance care planning is not valued, then patients/families and clinicians are not ready to initiate the process. Patients and clinicians are delaying conversations until “illness burden necessitates,” so there is little “advance” care planning, only care planning in-the-moment closer to the end of life. Discussion The value of advance care planning in collaboration with clinicians, patients and their surrogates needs reframing as an ongoing process early in the patient’s illness trajectory, distinguished from end-of-life decision making.

Church leaders and parishioners speak out about the role of the church in advance care planning and end-of-life care

2020 ◽  
pp. 1-7 ◽  
Author(s):  
Danetta Hendricks Sloan ◽  
Tamryn F. Gray ◽  
Darriel Harris ◽  
Theodora Peters ◽  
Anne Belcher ◽  
...  
Keyword(s):  
African American ◽  
End Of Life ◽  
Advance Care Planning ◽  
End Of Life Care ◽  
Well Being ◽  
Care Planning ◽  
Life Care ◽  
Advance Care ◽  
The Church

Abstract Objective Despite the increased focus on improving advance care planning (ACP) in African Americans through community partnerships, little published research focused on the role of the African American church in this effort. This study examines parishioner perceptions and beliefs about the role of the church in ACP and end-of-life care (EOLC). Method Qualitative interviews were completed with 25 church members (parishioners n = 15, church leader n = 10). The coding of data entailed a direct content analysis approach incorporating team experts for final themes. Results Seven themes emerged: (1) church role on end-of-life, (2) advocacy for health and well-being, (3) health literacy in EOLC, (4) lay health training on ACP and EOLC, (5) church recognized as a trusted source, (6) use of church ministries to sustain programs related to ACP and EOLC, and (7) community resources for EOLC needs. Significance of results The church has a central role in the African American Community. These findings suggest that involving African American churches in ACP and EOLC training can have a positive effect on facilitating planning and care during illness, dying, and death for their congregants.

Commentary: The Reluctant Surrogate

2016 ◽  
Vol 25 (2) ◽  
pp. 330-333
Author(s):  
Thomas Foreman
Keyword(s):  
Hospital Admission ◽  
Advance Care Planning ◽  
Clinical Ethics ◽  
Ethics Consultation ◽  
Care Team ◽  
Care Planning ◽  
Loved One ◽  
Advance Care ◽  
Regulatory Landscape

An individual’s hesitance or outright refusal to function as a substitute decisionmaker creates a number of challenges for treating teams, as is highlighted by the case of KS. It is not uncommon for individuals who suddenly find themselves in the role of substitute decisionmaker (SDM) to experience feelings of inadequacy or of being overwhelmed. The natural apprehension that comes with realizing, or being informed, that you are now responsible for providing or refusing consent on behalf of a loved one is often exacerbated by the accompanying circumstances. Even though there are movements afoot to encourage and support advance care planning and the inclusion of those who will become SDMs in conversations about values and wishes, there is still much work to be done. Although the case as presented does not provide information regarding what, if any, processes have taken place prior to the current hospital admission with regard to including the patient’s sister in discussions about future circumstances, it is clear that the sister feels unprepared to assume the role being thrust upon her. What, then, does a clinical ethics consultation have to offer in such situations? The following discussion highlights three ways in which ethics consultation can be of value to both the treating team and the identified SDM: ethics consultation (1) helps the care team and SDM navigate the regulatory landscape, (2) supports the treating team, and (3) supports the SDM.

End-of-life care in non-malignant conditions

2018 ◽  
Vol 11 (1) ◽  
pp. 41-47
Author(s):  
Rachel Lewis
Keyword(s):  
Palliative Care ◽  
Chronic Disease ◽  
End Of Life ◽  
Advance Care Planning ◽  
End Of Life Care ◽  
Care Planning ◽  
Life Care ◽  
High Quality ◽  
Advance Care

End-of-life care refers to the care of patients with progressive, incurable conditions and considered to be in the last year of life. Approximately 75% of end-of-life patients will die from non-malignant conditions. There are significant challenges, both in the identification of patients with chronic disease who are nearing the end of life and in the provision of high-quality palliative care in this group. This article explores the role of GPs in the management of end-of-life care in the most common non-malignant conditions, including management of symptoms and advance care planning.

Advance Care Planning

2019 ◽  
pp. 79-86
Author(s):  
Shigeko Izumi
Keyword(s):  
End Of Life ◽  
Advance Care Planning ◽  
Healthcare Providers ◽  
Care Planning ◽  
Life Care ◽  
Advance Care ◽  
Life Values ◽  
End Of Life Decision ◽  
Life Decision

Many patients and their families arrive at critical end-of-life decision-making ill-prepared, without any prior conversations about what the patient wants. Advance care planning is a process by which to reflect on and discuss a person’s life values and goals and to communicate preferences regarding future healthcare. The purpose is to ensure that people receive care that is consistent with their values, goals, and preferences at the end of their lives. The role of healthcare professionals is to support and encourage persons at any age or stage of health to begin these conversations to share their values and preferences with their families, friends, and healthcare providers so that their end-of-life care wishes are honored.

scholarly journals ADVANCE CARE PLANNING IN JAPANESE NURSING HOMES-USEFULNESS OF END-OF-LIFE CARE TEAM

2013 ◽  
Vol 3 (2) ◽  
pp. 285.1-285
Author(s):  
M Nishikawa ◽  
Y Yokoe ◽  
N Kubokawa ◽  
K Fukuda ◽  
H Hattori ◽  
...  
Keyword(s):  
Nursing Homes ◽  
End Of Life ◽  
Advance Care Planning ◽  
End Of Life Care ◽  
Care Team ◽  
Care Planning ◽  
Life Care ◽  
Advance Care
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