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Barriers to advance care planning with patients as perceived by nurses and other healthcare professionals: A systematic review

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Listed:
  • Douglas H. Blackwood
  • David Walker
  • Monty G. Mythen
  • Rachel M. Taylor
  • Cecilia Vindrola‐Padros

Abstract

Introduction Advance care planning is a means for patients to communicate their wishes, fears and desires for future health decisions should they lose the ability to consider or communicate these. Despite being supported by governments and healthcare leaders, uptake amongst the general population remains low. Nurses play a crucial role in promoting and engaging with these discussions given their close relationship with patients and families in a range of clinical settings. Aim To describe the barriers that nurses and healthcare professionals believe prevent them from exploring advance care planning with their patients. Method We carried out a systematic review of peer‐reviewed journal articles from the databases MEDLINE, Embase, CINAHL Plus, Web of Science and ProQuest Central, guided by the PRISMA checklist. Results Eleven articles were identified: all were self‐reporting surveys using a mix of open and closed questions. They originated in the USA, Canada, Australia and Ireland. The participants included various healthcare professionals, with the majority of studies focussing on nurses. The two most important barriers to advance care planning are lack of education and insufficient time. Advance care planning appears to be well supported, and nurses and healthcare professionals report themselves to be comfortable and confident to take on the responsibility. Conclusion There is a need for greater education and training for nurses and healthcare professionals. In particular, there needs to be better understanding of professional and legal responsibilities. The need for sufficient time to be made available to allow these conversations, in often busy settings, will need institutional and financial support. Relevance to clinical practice Increased training and knowledge are likely to lead to more positive attitudes and greater confidence for nurses, and other healthcare professionals, which should help support and encourage patient engagement with advance care planning.

Suggested Citation

  • Douglas H. Blackwood & David Walker & Monty G. Mythen & Rachel M. Taylor & Cecilia Vindrola‐Padros, 2019. "Barriers to advance care planning with patients as perceived by nurses and other healthcare professionals: A systematic review," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(23-24), pages 4276-4297, December.
    • Handle: RePEc:wly:jocnur:v:28:y:2019:i:23-24:p:4276-4297
    DOI: 10.1111/jocn.15049
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    References listed on IDEAS

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    1. Esther‐Ruth Beck & Sonja McIlfatrick & Felicity Hasson & Gerry Leavey, 2017. "Nursing home manager's knowledge, attitudes and beliefs about advance care planning for people with dementia in long‐term care settings: a cross‐sectional survey," Journal of Clinical Nursing, John Wiley & Sons, vol. 26(17-18), pages 2633-2645, September.
    2. Li‐Shan Ke & Xiaoyan Huang & Margaret O'Connor & Susan Lee, 2015. "Nurses' views regarding implementing advance care planning for older people: a systematic review and synthesis of qualitative studies," Journal of Clinical Nursing, John Wiley & Sons, vol. 24(15-16), pages 2057-2073, August.
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    Cited by:

    1. Anne Kuusisto & Jenni Santavirta & Kaija Saranto & Elina Haavisto, 2021. "Healthcare professionals’ perceptions of advance care planning in palliative care unit: a qualitative descriptive study," Journal of Clinical Nursing, John Wiley & Sons, vol. 30(5-6), pages 633-644, March.
    2. Suet Ying Ng & Eliza Lai-Yi Wong, 2021. "The Role Complexities in Advance Care Planning for End-of-Life Care—Nursing Students’ Perception of the Nursing Profession," IJERPH, MDPI, vol. 18(12), pages 1-13, June.
    3. Silvia Sörensen & Rachel L. Missell & Alexander Eustice‐Corwin & Dorine A. Otieno, 2021. "Perspectives on Aging‐Related Preparation," Journal of Elder Policy, John Wiley & Sons, vol. 1(2), pages 163-221, March.
    4. Hsueh-Hsing Pan & Li-Fen Wu & Li-Fang Chang & Yu-Chun Hung & Chin Lin & Ching-Liang Ho, 2021. "Effects of Dispositional Resilience and Self-Efficacy on Practice in Advanced Care Planning of Terminally Ill Patients among Taiwanese Nurses: A Study Using Path Modeling," IJERPH, MDPI, vol. 18(3), pages 1-12, January.

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