An integrative review of stakeholder views on Advance Care Directives (ACD): Barriers and facilitators to initiation, documentation, storage, and implementation

被引：38

作者：

Hemsley, Bronwyn ^{[1
,2
]}

Meredith, Jacqueline ^{[3
]}

Bryant, Lucy ^{[1
,2
]}

Wilson, Nathan J. ^{[4
]}

Higgins, Isabel ^{[3
]}

Georgiou, Andrew ^{[5
]}

Hill, Sophie ^{[6
]}

Balandin, Susan ^{[7
]}

McCarthy, Shaun ^{[3
]}

机构：

[1] Univ Technol Sydney, Fac Sci, 67 Thomas St, Ultimo, NSW, Australia

[2] Univ Technol Sydney, Grad Sch Hlth Bldg, 67 Thomas St, Ultimo, NSW, Australia

[3] Univ Newcastle, Univ Dr, Callaghan, NSW 2308, Australia

[4] Western Sydney Univ, Bldg G10 Off 10,Hawkesbury Campus,Locked Bag 1797, Penrith, NSW 1797, Australia

[5] Macquarie Univ, Room L6 36,Level 6,75 Talavera Rd, Macquarie Park, NSW, Australia

[6] La Trobe Univ, Coll Sci Hlth & Engn, Sch Psychol & Publ Hlth, Melbourne, Vic 3086, Australia

[7] Deakin Univ, Melbourne Burwood Campus,221 Burwood Highway, Burwood, Vic 3125, Australia

来源：

PATIENT EDUCATION AND COUNSELING | 2019年 / 102卷 / 06期

基金：

英国医学研究理事会;

关键词：

Advance care planning; Advance Care Directive; End-of-life care; Patient views; OF-LIFE CARE; OBSTRUCTIVE PULMONARY-DISEASE; PALLIATIVE CARE; DECISION-MAKING; OLDER-PEOPLE; GENERAL-PRACTITIONERS; AUSTRALIA FINDINGS; FAILURE PATIENTS; CANCER-PATIENTS; ETHICAL-ISSUES;

D O I：

10.1016/j.pec.2019.01.007

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Objective: To examine the views and experiences of patients and their health care providers on developing advance care planning (ACP) and advance care directives (ACD); and determine barriers and facilitators to ACD development, storage, and use, including implications for people with communication disability. Method: An integrative review of 93 studies, analysed according to their content themes. Results: Content themes encapsulated the initiation, documentation, and implementation stages of ACP/ACD. Lack of guidance for initiating and supporting ACP/ACD impedes discussions, and both patients and healthcare providers avoid discussions owing to fear of dying and reluctance to think about end-of-life. Conclusions: There are several barriers and facilitators to the initiation of ACP discussions, documentation and implementation of ACD, and little research exploring the views of legal professionals on the development, storage, or use of ACP documents. Further research is needed to explore the timing and responsibility of both legal and health professionals in initiating and supporting ACP discussions. Practice Implications: It is important for healthcare providers to raise ACP discussions regularly so that patients have time to make informed advance care decisions. Storage of the document in an electronic health record might facilitate better access to and implementation of patients' end-of-life care decisions. (C) 2019 Elsevier B.V. All rights reserved.

引用

页码：1067 / 1079

页数：13

共 102 条

[1]

[Anonymous], NAT FRAM ADV CAR DIR

[2]

[Anonymous], 2011, CAPACITY LAW

[3]

[Anonymous], 2017, PERSPECT HLTH INF MA

[4] Advance Care Planning: Understanding Clinical Routines and Experiences of Interprofessional Team Members in Diverse Health Care Settings [J].