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Nurses' views regarding implementing advance care planning for older people: a systematic review and synthesis of qualitative studies

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  • Li‐Shan Ke
  • Xiaoyan Huang
  • Margaret O'Connor
  • Susan Lee

Abstract

Aims and objectives To explore nurses' views regarding implementing advance care planning for older people. Background Advance care planning is recommended as a way for older people to discuss their future care with family members and health professionals. Nurses play key roles in the process of advance care planning, including ensuring that patients are informed of their rights and that decisions are known to, and respected by, the health care team. Thus, understanding of nurses' experiences and perspectives regarding implementing advance care planning for older people is a significant topic for review. Design Qualitative meta‐synthesis. Methods Four databases including CINAHL plus, Medline [EBSCOhost], EMBASE, and PsycINFO were searched, and 1844 articles were initially screened. Finally, 18 articles were critically appraised and a thematic synthesis was undertaken. Results Four themes were identified regarding implementation of advance care planning: perceived disadvantages and advantages of advance directives; nurses' responsibility and roles; facilitators and barriers; and nurses' needs and recommendations. Nurses felt that advance directives provided more advantages than disadvantages. Nurses generally believed that they were well positioned to engage in advance care planning conversations. Nurses perceived barriers relating to older people, families, environment, time, culture, cost, language and knowledge of health care teams with regard to advance care planning. In nurses' needs, education and support were highlighted. Conclusions This study provides useful knowledge for implementing advance care planning through illustrating nurses' experiences and perspectives. The results showed that nurses were more concerned about barriers in relation to working environment, teamwork, time and knowledge of health care team members than older people's characteristics, when implementing advance care planning. Relevance to clinical practice The findings provide nurses and administrators with information to develop related policies and education. Additionally, the appointment of nurses to formal roles related to advance care planning is appropriate and warranted.

Suggested Citation

  • 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.
    • Handle: RePEc:wly:jocnur:v:24:y:2015:i:15-16:p:2057-2073
    DOI: 10.1111/jocn.12853
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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. 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.
    4. Rebecca Carabez & Megan Scott, 2016. "‘Nurses don't deal with these issues’: nurses’ role in advance care planning for lesbian, gay, bisexual and transgender patients," Journal of Clinical Nursing, John Wiley & Sons, vol. 25(23-24), pages 3707-3715, December.
    5. I-Hui Chen & Shu-Fen Kuo & Yen-Kuang Lin & Tsai-Wei Huang, 2022. "Knowledge of and Barriers to Palliative Care Perceived by Healthcare Providers before and after Promotion of the Patient Autonomy Act: A Cross-Sectional Study," IJERPH, MDPI, vol. 19(7), pages 1-13, March.

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