"I decide myself"- A qualitative exploration of end of life decision making processes of patients and caregivers through Advance Care Planning.

<h4>Background</h4>The Singapore national Advance Care Planning (ACP) programme was launched in 2011 with the purpose of ensuring that healthcare professionals are fully aware of patients' treatment preferences. There is little research assessing the performance of such programmes i...

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Autores principales:	Priya Lall, Oindrila Dutta, Woan Shin Tan, Paul Victor Patinadan, Natalie Q Y Kang, Chan Kee Low, Josip Car, Andy Hau Yan Ho
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/c79c7a05e7f648bfbf43bb250be6c0cd
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spelling	oai:doaj.org-article:c79c7a05e7f648bfbf43bb250be6c0cd2021-12-02T20:10:24Z"I decide myself"- A qualitative exploration of end of life decision making processes of patients and caregivers through Advance Care Planning.1932-620310.1371/journal.pone.0252598https://doaj.org/article/c79c7a05e7f648bfbf43bb250be6c0cd2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0252598https://doaj.org/toc/1932-6203<h4>Background</h4>The Singapore national Advance Care Planning (ACP) programme was launched in 2011 with the purpose of ensuring that healthcare professionals are fully aware of patients' treatment preferences. There is little research assessing the performance of such programmes in ethnically diverse Asian countries; hence, the purpose of this study was to qualitatively examine patients and caregivers' experiences with the ACP programme.<h4>Method</h4>We conducted interviews with 28 participants, thirteen of whom identified as proxy decision makers (PDMs) and the remainder as patients. Interviews focused on respondents' experiences of chronic illness and of participating in the ACP programme. Textual data was analysed through a framework analysis approach.<h4>Results</h4>Participants' narratives focused on four major themes with 12 subthemes: a) Engagement with Death, factors influencing respondents' acceptance of ACP; b) Formation of Preferences, the set of concerns influencing respondents' choice of care; c) Choice of PDM, considerations shaping respondents' choice of nominated health spokesperson; and d) Legacy Solidification, how ACP is used to ensure the welfare of the family after the patient passes. These findings led to our development of the directive decision-making process framework, which delineates personal and sociocultural factors influencing participants' decision-making processes. Respondents' continual participation in the intervention were driven by their personal belief system that acted as a lens through which they interpreted religious doctrine and socio-cultural norms according to their particular needs.<h4>Conclusion</h4>The directive decision-making process framework indicated that ACP could be appropriate for the Asian context because participants displayed an awareness of the need for ACP and were able to develop a concrete treatment plan. Patients in this study made decisions based on their perceived long-term legacy for their family, who they hoped to provide with a solid financial and psychological foundation after their death.Priya LallOindrila DuttaWoan Shin TanPaul Victor PatinadanNatalie Q Y KangChan Kee LowJosip CarAndy Hau Yan HoPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0252598 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Priya Lall Oindrila Dutta Woan Shin Tan Paul Victor Patinadan Natalie Q Y Kang Chan Kee Low Josip Car Andy Hau Yan Ho "I decide myself"- A qualitative exploration of end of life decision making processes of patients and caregivers through Advance Care Planning.
description	<h4>Background</h4>The Singapore national Advance Care Planning (ACP) programme was launched in 2011 with the purpose of ensuring that healthcare professionals are fully aware of patients' treatment preferences. There is little research assessing the performance of such programmes in ethnically diverse Asian countries; hence, the purpose of this study was to qualitatively examine patients and caregivers' experiences with the ACP programme.<h4>Method</h4>We conducted interviews with 28 participants, thirteen of whom identified as proxy decision makers (PDMs) and the remainder as patients. Interviews focused on respondents' experiences of chronic illness and of participating in the ACP programme. Textual data was analysed through a framework analysis approach.<h4>Results</h4>Participants' narratives focused on four major themes with 12 subthemes: a) Engagement with Death, factors influencing respondents' acceptance of ACP; b) Formation of Preferences, the set of concerns influencing respondents' choice of care; c) Choice of PDM, considerations shaping respondents' choice of nominated health spokesperson; and d) Legacy Solidification, how ACP is used to ensure the welfare of the family after the patient passes. These findings led to our development of the directive decision-making process framework, which delineates personal and sociocultural factors influencing participants' decision-making processes. Respondents' continual participation in the intervention were driven by their personal belief system that acted as a lens through which they interpreted religious doctrine and socio-cultural norms according to their particular needs.<h4>Conclusion</h4>The directive decision-making process framework indicated that ACP could be appropriate for the Asian context because participants displayed an awareness of the need for ACP and were able to develop a concrete treatment plan. Patients in this study made decisions based on their perceived long-term legacy for their family, who they hoped to provide with a solid financial and psychological foundation after their death.
format	article
author	Priya Lall Oindrila Dutta Woan Shin Tan Paul Victor Patinadan Natalie Q Y Kang Chan Kee Low Josip Car Andy Hau Yan Ho
author_facet	Priya Lall Oindrila Dutta Woan Shin Tan Paul Victor Patinadan Natalie Q Y Kang Chan Kee Low Josip Car Andy Hau Yan Ho
author_sort	Priya Lall
title	"I decide myself"- A qualitative exploration of end of life decision making processes of patients and caregivers through Advance Care Planning.
title_short	"I decide myself"- A qualitative exploration of end of life decision making processes of patients and caregivers through Advance Care Planning.
title_full	"I decide myself"- A qualitative exploration of end of life decision making processes of patients and caregivers through Advance Care Planning.
title_fullStr	"I decide myself"- A qualitative exploration of end of life decision making processes of patients and caregivers through Advance Care Planning.
title_full_unstemmed	"I decide myself"- A qualitative exploration of end of life decision making processes of patients and caregivers through Advance Care Planning.
title_sort	"i decide myself"- a qualitative exploration of end of life decision making processes of patients and caregivers through advance care planning.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/c79c7a05e7f648bfbf43bb250be6c0cd
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"I decide myself"- A qualitative exploration of end of life decision making processes of patients and caregivers through Advance Care Planning.

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