TY - JOUR
T1 - Advance Care Planning conversations
T2 - What constitutes best practice and the way forward: Advance Care Planning-Gespräche: Was Best Practice ausmacht und wie es weitergehen kann
AU - Nortje, Nico
AU - Zachariah, Finly
AU - Reddy, Akhila
N1 - Publisher Copyright:
© 2023
PY - 2023/8
Y1 - 2023/8
N2 - Background: Advance Care Planning (ACP) conversations are a cornerstone of modern health care and need to be supported. However, research indicates that the uptake thereof is limited, regardless of various campaigns. ACP conversations are complex and specific elements thereof should be discussed at various timepoints during the illness trajectory. Objective: This narrative review delineates what ACP conversation should entail, and a way forward. Methods: A PEO (Population, Exposure, Outcome) search was performed using relevant keywords, and 615 articles were identified. Through screening and coding, this number was reduced to 24 articles. All the authors were involved in the final selection of the articles. Results: Various themes developed throughout the review which include timing early on in the disease trajectory; incorporating beliefs and culturally relevant contexts; conversations needing to be iterative and short; involving surrogates and family; applying various media formats. Discussion: ACP conversations are relevant. ACP is not static and needs to be dynamic as patients’ illness trajectories and goals change. The care team needs to guard themselves against having ACP conversations to satisfy a metric and should instead be guided by the patient's expressed values and wishes. A system-wide operational plan will help alleviate common barriers in having appropriate ACP conversations.
AB - Background: Advance Care Planning (ACP) conversations are a cornerstone of modern health care and need to be supported. However, research indicates that the uptake thereof is limited, regardless of various campaigns. ACP conversations are complex and specific elements thereof should be discussed at various timepoints during the illness trajectory. Objective: This narrative review delineates what ACP conversation should entail, and a way forward. Methods: A PEO (Population, Exposure, Outcome) search was performed using relevant keywords, and 615 articles were identified. Through screening and coding, this number was reduced to 24 articles. All the authors were involved in the final selection of the articles. Results: Various themes developed throughout the review which include timing early on in the disease trajectory; incorporating beliefs and culturally relevant contexts; conversations needing to be iterative and short; involving surrogates and family; applying various media formats. Discussion: ACP conversations are relevant. ACP is not static and needs to be dynamic as patients’ illness trajectories and goals change. The care team needs to guard themselves against having ACP conversations to satisfy a metric and should instead be guided by the patient's expressed values and wishes. A system-wide operational plan will help alleviate common barriers in having appropriate ACP conversations.
KW - ACP conversations
KW - Cancer
KW - Improving goal concordant care initiative
UR - http://www.scopus.com/inward/record.url?scp=85164488915&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85164488915&partnerID=8YFLogxK
U2 - 10.1016/j.zefq.2023.05.008
DO - 10.1016/j.zefq.2023.05.008
M3 - Article
C2 - 37438167
AN - SCOPUS:85164488915
SN - 1865-9217
VL - 180
SP - 8
EP - 15
JO - Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen
JF - Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen
ER -