Advance care planning in stroke: Influence of time on engagement in the process

Green, Theresa, Gandhi, Shreyas, Kleissen, Tessa, Simon, Jessica, Raffin-Bouchal, Shelley, & Ryckborst, Karla (2014) Advance care planning in stroke: Influence of time on engagement in the process. Patient Preference and Adherence, 2014(8), pp. 119-126.

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Abstract

Purpose

Individuals who experience stroke have a higher likelihood of subsequent stroke events, making it imperative to plan for future medical care. In the event of a further serious health event, engaging in the process of advanced care planning (ACP) can help family members and health care professionals (HCPs) make medical decisions for individuals who have lost the capacity to do so. Few studies have explored the views and experiences of patients with stroke about discussing their wishes and preferences for future medical events, and the extent to which stroke HCPs engage in conversations around planning for such events. In this study, we sought to understand how the process of ACP unfolded between HCPs and patients post-stroke.

Patients and methods

Using grounded theory (GT) methodology, we engaged in direct observation of HCP and patient interactions on an acute stroke unit and two stroke rehabilitation units. Using semi-structured interviews, 14 patients and four HCPs were interviewed directly about the ACP process.

Results

We found that open and continual ACP conversations were not taking place, patients experienced an apparent lack of urgency to engage in ACP, and HCPs were uncomfortable initiating ACP conversations due to the sensitive nature of the topic.

Conclusion

In this study, we identified lack of engagement in ACP post-stroke, attributable to patient and HCP factors. This encourages us to look further into the process of ACP in order to develop open communication between the patient with stroke, their families, and stroke HCPs.

Impact and interest:

1 citations in Scopus
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1 citations in Web of Science®

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ID Code: 85045
Item Type: Journal Article
Refereed: Yes
Keywords: Engagement, Health care providers, Palliative, Qualitative
DOI: 10.2147/PPA.S54822
ISSN: 1177-889X
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000) > Nursing not elsewhere classified (111099)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Nursing
Deposited On: 30 Jun 2015 22:42
Last Modified: 03 Jul 2015 00:47

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