Improving person-centered advance care planning conversation with older people: a qualitative study of core components perceived by healthcare professionals
- VernacularTitle:Improving person-centered advance care planning conversation with older people: a qualitative study of core components perceived by healthcare professionals
- Author:
Tsukasa MURAYA
1
;
Yuko AKAGAWA
2
;
Hideaki ANDOH
2
;
Chifa CHIANG
3
;
Yoshihisa HIRAKAWA
3
Author Information
- Keywords: person-centered care; advance care planning; practice guideline; paternalism; multidisciplinary collaboration
- From:Journal of Rural Medicine 2021;16(4):222-228
- CountryJapan
- Language:English
- Abstract: Objective: The non-medical needs of patients, such as values and personal preferences, are likely to be omitted from advance care planning (ACP) discussions because of a lack of readiness and awareness on the part of healthcare professionals. The aim of the present study was to identify core components perceived by multidisciplinary healthcare professionals to improve person-centered ACP conversations with older people.Methods: The study participants were healthcare professionals (physicians, nurses, and care managers) working in different cities. This qualitative study was performed online using eight individual in-depth interviews and one subsequent focus group composed of eight healthcare professionals. The interviews and focus group discussion were audio-recorded online and transcribed verbatim. The aim of the analysis of the individual in-depth interviews was to summarize the transcribed results, create a conceptual framework for person-centered ACP conversation, and provide meaningful interpretations of the focus group participant discourse. The qualitative data were then analyzed by inductive manual coding using a qualitative content analysis approach.Results: Five themes capturing the core components for successful person-centered ACP were extracted from the ideas voiced by participants: Placing highest value on patient autonomy and human life; uncovering patient’s true feelings and desires; sharing collected information on patients’ end-of-life wishes with other team members; relaying patients’ wishes to the physician; and handling conflicts among patients, relatives, and healthcare professionals.Conclusion: The results provide guidelines for the future development of novel, value-based, person-centered ACP practice for multidisciplinary healthcare professionals.
