A Qualitative Study of Nursing Home Staff Lived Experience With Advance Care Planning
Copyright © 2023 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved..
OBJECTIVE: Advance care planning (ACP) within nursing homes (NHs) is an integral component of resident-centered care yet remains an ongoing area for improvement. This study explored health care providers' experiences when facilitating ACP discussions with residents and their families.
DESIGN: Interpretive description was used to explore meanings and generate knowledge that is applicable for clinical contexts.
SETTING AND PARTICIPANTS: A purposive sample of 27 staff members (2 directors of care, 3 assistant directors of care, 1 nurse practitioner, 11 registered nurses, 3 registered practical nurses, and 7 social workers) from 29 NHs located across 3 Canadian provinces that participated in cluster-randomized intervention study to improve ACP.
METHODS: Semistructured interviews were conducted between January and July 2020. Interpretive description methods were used for analysis.
RESULTS: Three themes were identified. "Navigating Relational Tensions During ACP with Families" captures the relational tensions that participants experienced while navigating ACP processes with residents and their families. The second theme, "Where's the Doctor?" highlights the general lack of physician involvement in ACP discussions and the subsequent pressures faced by participants when supporting residents and families. The last theme, "Crises Change the Best Laid Plans," illustrates the challenges participants face when trying to adhere to existing care plans during residents' medical crises.
CONCLUSION AND IMPLICATIONS: Participants' experiences indicate that current ACP processes in NHs do not meet the needs of residents, families, or care teams. Additional support from physicians and changes to structural processes are needed to support resident-centered end-of-life planning within this care context.
Medienart: |
E-Artikel |
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Erscheinungsjahr: |
2023 |
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Erschienen: |
2023 |
Enthalten in: |
Zur Gesamtaufnahme - volume:24 |
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Enthalten in: |
Journal of the American Medical Directors Association - 24(2023), 11 vom: 15. Nov., Seite 1761-1766 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Quail, Patrick [VerfasserIn] |
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Links: |
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Themen: |
Advance care planning |
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Anmerkungen: |
Date Completed 30.10.2023 Date Revised 30.10.2023 published: Print-Electronic Citation Status MEDLINE |
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doi: |
10.1016/j.jamda.2023.06.027 |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
NLM360363865 |
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500 | |a Citation Status MEDLINE | ||
520 | |a Copyright © 2023 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved. | ||
520 | |a OBJECTIVE: Advance care planning (ACP) within nursing homes (NHs) is an integral component of resident-centered care yet remains an ongoing area for improvement. This study explored health care providers' experiences when facilitating ACP discussions with residents and their families | ||
520 | |a DESIGN: Interpretive description was used to explore meanings and generate knowledge that is applicable for clinical contexts | ||
520 | |a SETTING AND PARTICIPANTS: A purposive sample of 27 staff members (2 directors of care, 3 assistant directors of care, 1 nurse practitioner, 11 registered nurses, 3 registered practical nurses, and 7 social workers) from 29 NHs located across 3 Canadian provinces that participated in cluster-randomized intervention study to improve ACP | ||
520 | |a METHODS: Semistructured interviews were conducted between January and July 2020. Interpretive description methods were used for analysis | ||
520 | |a RESULTS: Three themes were identified. "Navigating Relational Tensions During ACP with Families" captures the relational tensions that participants experienced while navigating ACP processes with residents and their families. The second theme, "Where's the Doctor?" highlights the general lack of physician involvement in ACP discussions and the subsequent pressures faced by participants when supporting residents and families. The last theme, "Crises Change the Best Laid Plans," illustrates the challenges participants face when trying to adhere to existing care plans during residents' medical crises | ||
520 | |a CONCLUSION AND IMPLICATIONS: Participants' experiences indicate that current ACP processes in NHs do not meet the needs of residents, families, or care teams. Additional support from physicians and changes to structural processes are needed to support resident-centered end-of-life planning within this care context | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a Research Support, Non-U.S. Gov't | |
650 | 4 | |a Advance care planning | |
650 | 4 | |a end-of-life care | |
650 | 4 | |a long-term care | |
650 | 4 | |a nursing homes | |
650 | 4 | |a qualitative | |
650 | 4 | |a resident-centered care | |
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700 | 1 | |a Boscart, Veronique |e verfasserin |4 aut | |
700 | 1 | |a Ramsey, Clare |e verfasserin |4 aut | |
700 | 1 | |a Garland, Allan |e verfasserin |4 aut | |
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