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

Hemsley, B; Meredith, J; Bryant, L; Wilson, NJ; Higgins, I; Georgiou, A; Hill, S; Balandin, S; McCarthy, S

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

Hemsley, B

Meredith, J Bryant, L

Wilson, NJ Higgins, I Georgiou, A Hill, S Balandin, S McCarthy, S

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Publication Type:: Journal Article
Citation:: Patient Education and Counseling, 2019, 102 (6), pp. 1067 - 1079
Issue Date:: 2019-06-01

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Field	Value	Language
dc.contributor.author	Hemsley, B https://orcid.org/0000-0002-6255-3140	en_US
dc.contributor.author	Meredith, J	en_US
dc.contributor.author	Bryant, L https://orcid.org/0000-0001-8497-7406	en_US
dc.contributor.author	Wilson, NJ	en_US
dc.contributor.author	Higgins, I	en_US
dc.contributor.author	Georgiou, A	en_US
dc.contributor.author	Hill, S	en_US
dc.contributor.author	Balandin, S	en_US
dc.contributor.author	McCarthy, S	en_US
dc.date.available	2019-01-10	en_US
dc.date.issued	2019-06-01	en_US
dc.identifier.citation	Patient Education and Counseling, 2019, 102 (6), pp. 1067 - 1079	en_US
dc.identifier.issn	0738-3991	en_US
dc.identifier.uri	http://hdl.handle.net/10453/134866
dc.description.abstract	© 2019 Elsevier B.V. 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.	en_US
dc.relation	http://purl.org/au-research/grants/nhmrc/APP1058094
dc.relation.ispartof	Patient Education and Counseling	en_US
dc.relation.isbasedon	10.1016/j.pec.2019.01.007	en_US
dc.subject.classification	Public Health	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Professional-Family Relations	en_US
dc.subject.mesh	Professional-Patient Relations	en_US
dc.subject.mesh	Decision Making	en_US
dc.subject.mesh	Advance Directives	en_US
dc.subject.mesh	Documentation	en_US
dc.subject.mesh	Information Storage and Retrieval	en_US
dc.subject.mesh	Advance Care Planning	en_US
dc.subject.mesh	Stakeholder Participation	en_US
dc.title	An integrative review of stakeholder views on Advance Care Directives (ACD): Barriers and facilitators to initiation, documentation, storage, and implementation	en_US
dc.type	Journal Article
utslib.citation.volume	6	en_US
utslib.citation.volume	102	en_US
utslib.for	170204 Linguistic Processes (incl. Speech Production and Comprehension)	en_US
utslib.for	11 Medical and Health Sciences	en_US
utslib.for	17 Psychology and Cognitive Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
utslib.copyright.status	closed_access
pubs.issue	6	en_US
pubs.publication-status	Published	en_US
pubs.volume	102	en_US

Abstract:

© 2019 Elsevier B.V. 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.

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http://hdl.handle.net/10453/134866