Significance of advance care planning in nursing homes: views from patients with cognitive impairment, their next of kin, health personnel, and managers

Trygve Johannes Lereim Sævareid,1 Reidun Førde,1 Lisbeth Thoresen,1,2 Lillian Lillemoen,1 Reidar Pedersen11Centre for Medical Ethics, University of Oslo, Oslo, Norway; 2Department of Health Sciences, University of Oslo, Oslo, NorwayPurpose: Advance care planning (ACP) performed...

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Autores principales:	Sævareid TJL, Førde R, Thoresen L, Lillemoen L, Pedersen R
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	qualitative person-centered care whole-system approach implementation cognitive impairment. Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/2b21149e44ab40f99009b95b7b99053a
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spelling	oai:doaj.org-article:2b21149e44ab40f99009b95b7b99053a2021-12-02T09:37:40ZSignificance of advance care planning in nursing homes: views from patients with cognitive impairment, their next of kin, health personnel, and managers1178-1998https://doaj.org/article/2b21149e44ab40f99009b95b7b99053a2019-05-01T00:00:00Zhttps://www.dovepress.com/significance-of-advance-care-planning-in-nursing-homes-views-from-pati-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Trygve Johannes Lereim Sævareid,1 Reidun Førde,1 Lisbeth Thoresen,1,2 Lillian Lillemoen,1 Reidar Pedersen11Centre for Medical Ethics, University of Oslo, Oslo, Norway; 2Department of Health Sciences, University of Oslo, Oslo, NorwayPurpose: Advance care planning (ACP) performed by regular staff, which also includes patients with cognitive impairment and their next of kin, is scarcely studied. Thus, we planned an implementation study including key stakeholders (patients, next of kin, and health care personnel) using a whole-ward/system approach to ACP. We explored how they experienced ACP and its significance.Patients and methods: This qualitative study is part of a mixed-method implementation study of ACP. In four nursing homes, we did qualitative interviews and audio-recordings of meetings. We completed 20 individual semistructured interviews with participants soon after ACP conversations. The interviews included patients with cognitive impairment, their next of kin, and health care personnel. We also conducted four focus group interviews with staff and managers in the nursing homes and audio-recorded four network meetings with the project teams implementing ACP.Results: All participants appreciated taking part in ACP. Patients and next of kin focused more on the past and present than future treatment preferences. Still, ACP seemed to contribute to a stronger patient focus on end-of-life conversations. More generally, ACP seemed to contribute to valuable information for future decision-making, trusting relations, improved end-of-life communication, and saving time and resources.Conclusion: Safeguarding a strong patient focus on ACP and fostering a person-centered care culture in nursing home wards seem to be achievable through implementation of ACP that includes regular staff, patients with cognitive impairment, and their next of kin.Keywords: qualitative, person-centered care, whole-system approach, implementation, cognitive impairmentSævareid TJLFørde RThoresen LLillemoen LPedersen RDove Medical Pressarticlequalitativeperson-centered carewhole-system approachimplementationcognitive impairment.GeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 14, Pp 997-1005 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	qualitative person-centered care whole-system approach implementation cognitive impairment. Geriatrics RC952-954.6
spellingShingle	qualitative person-centered care whole-system approach implementation cognitive impairment. Geriatrics RC952-954.6 Sævareid TJL Førde R Thoresen L Lillemoen L Pedersen R Significance of advance care planning in nursing homes: views from patients with cognitive impairment, their next of kin, health personnel, and managers
description	Trygve Johannes Lereim Sævareid,1 Reidun Førde,1 Lisbeth Thoresen,1,2 Lillian Lillemoen,1 Reidar Pedersen11Centre for Medical Ethics, University of Oslo, Oslo, Norway; 2Department of Health Sciences, University of Oslo, Oslo, NorwayPurpose: Advance care planning (ACP) performed by regular staff, which also includes patients with cognitive impairment and their next of kin, is scarcely studied. Thus, we planned an implementation study including key stakeholders (patients, next of kin, and health care personnel) using a whole-ward/system approach to ACP. We explored how they experienced ACP and its significance.Patients and methods: This qualitative study is part of a mixed-method implementation study of ACP. In four nursing homes, we did qualitative interviews and audio-recordings of meetings. We completed 20 individual semistructured interviews with participants soon after ACP conversations. The interviews included patients with cognitive impairment, their next of kin, and health care personnel. We also conducted four focus group interviews with staff and managers in the nursing homes and audio-recorded four network meetings with the project teams implementing ACP.Results: All participants appreciated taking part in ACP. Patients and next of kin focused more on the past and present than future treatment preferences. Still, ACP seemed to contribute to a stronger patient focus on end-of-life conversations. More generally, ACP seemed to contribute to valuable information for future decision-making, trusting relations, improved end-of-life communication, and saving time and resources.Conclusion: Safeguarding a strong patient focus on ACP and fostering a person-centered care culture in nursing home wards seem to be achievable through implementation of ACP that includes regular staff, patients with cognitive impairment, and their next of kin.Keywords: qualitative, person-centered care, whole-system approach, implementation, cognitive impairment
format	article
author	Sævareid TJL Førde R Thoresen L Lillemoen L Pedersen R
author_facet	Sævareid TJL Førde R Thoresen L Lillemoen L Pedersen R
author_sort	Sævareid TJL
title	Significance of advance care planning in nursing homes: views from patients with cognitive impairment, their next of kin, health personnel, and managers
title_short	Significance of advance care planning in nursing homes: views from patients with cognitive impairment, their next of kin, health personnel, and managers
title_full	Significance of advance care planning in nursing homes: views from patients with cognitive impairment, their next of kin, health personnel, and managers
title_fullStr	Significance of advance care planning in nursing homes: views from patients with cognitive impairment, their next of kin, health personnel, and managers
title_full_unstemmed	Significance of advance care planning in nursing homes: views from patients with cognitive impairment, their next of kin, health personnel, and managers
title_sort	significance of advance care planning in nursing homes: views from patients with cognitive impairment, their next of kin, health personnel, and managers
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/2b21149e44ab40f99009b95b7b99053a
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Significance of advance care planning in nursing homes: views from patients with cognitive impairment, their next of kin, health personnel, and managers

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