A literature review: Advance directives and patients with implantable cardioverter defibrillators

Conelius, Jaclyn

doi:10.1111/j.1745-7599.2010.00499.x

Cited by 6 publications

(11 citation statements)

References 19 publications

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“…and family well, 46,59,62 and who are well trained in ACP facilitation. 56,65 Literature in nursing homes highlighted that while patients and carers wanted health care professionals to initiate ACP discussions, they were concerned about whether the professionals had the capacity to engage in these discussions because of staff shortages.…”

Section: Initiation Of Acp Discussionmentioning

confidence: 99%

“…61,65 Some reviews showed that patients and carers recognized that ACP discussions may be recurring events rather than one-off exercises. This seemed to be particularly relevant in the context of heart disease, 44,59 where patients may wish to discuss their options at specific transitions in their care and revise their opinions on the use of implantable defibrillators. Other reviews that did not focus on a particular health condition also found preferences for recurring ACP discussion.…”

Section: Timing Of Acp Discussionmentioning

confidence: 99%

“…52 In a range of different contexts, there were calls for further exploration of patient and carer understandings of ACP, understandings of patients' illnesses and their end-of-life wishes, and how family relationships affect decision making. 31,32,55,59,72,75 Research on ACP for individuals with intellectual disabilities will need to overcome the methodological complexities in involving this group. 33,34 Other reviews focused on intervention development and evaluation, particularly on formats and timing of ACP.…”

Section: Recommendations For Researchmentioning

confidence: 99%

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How Should End-of-Life Advance Care Planning Discussions Be Implemented According to Patients and Informal Carers? A Qualitative Review of Reviews

Hall

Rowland

Grande

2019

Journal of Pain and Symptom Management

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Context. The goal of advance care planning (ACP) is to help ensure that the care people receive during periods of serious illness is consistent with their preferences and values. There is a lack of clear understanding about how patients and their informal carers feel ACP discussions should be implemented. Objectives. The objective of this study was to synthesize literature reviews pertaining to patients' and informal carers' perspectives on ACP discussions. Methods. This is a systematic review of reviews. Results. We identified 55 literature reviews published between 2007 and 2018. ACP discussions were facilitated by a diverse range of formats and tools, all of which were acceptable to patients and carers. Patients and carers preferred health professionals to initiate discussions, with the relationships they had with the professionals being particularly important. There were mixed feelings about the best timing, with many people preferring to defer discussions until they perceived them to be clinically relevant. ACP was felt to bring benefits including a greater sense of peace and less worry, but it could also be disruptive and distressing. Patients and carers perceived many benefits from ACP discussions, but these may differ from the dominant narratives about ACP in health policy and may move away from the narratives of RCTs and standardization in research and practice. Conclusion. Researchers and clinicians may need to adjust their approaches as current practices are not aligned enough with patients' and carers' preferences. Future research may need to test implementation strategies of ACP interventions to elucidate how benefits from standardization and flexibility might both be realized.

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Section: Initiation Of Acp Discussionmentioning

confidence: 99%

Section: Timing Of Acp Discussionmentioning

confidence: 99%

Section: Recommendations For Researchmentioning

confidence: 99%

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How Should End-of-Life Advance Care Planning Discussions Be Implemented According to Patients and Informal Carers? A Qualitative Review of Reviews

Hall

Rowland

Grande

2019

Journal of Pain and Symptom Management

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“…Completion rates for ADs increased when information was given to participants in advance of their admission [3]. This literature review has tried to demonstrate different kinds of patient education in increasing ADs completion rates.…”

Section: Resultsmentioning

confidence: 99%

“…Advance directives (ADs) were formal statement made by a person about how he wants medical decisions for himself made and who should make these decisions when he can no longer make such decisions for himself [8]. There are two kinds of ADs: living will (LW) which is a treatment directive, and appointment directive that is durable power of attorney for health care (DPHAC) [3]. ICGH Conference Proceedings…”

Section: Introductionmentioning

confidence: 99%

Critical Appraisal Topic on Patient Education on Advance Directives in End-of-Life Care

Komalasari

2018

KLS

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The Development, Refinement, and Psychometric Testing of the Attitude Toward Advanced Directive Survey in Implantable Cardioverter Defibrillator Patients

Conelius¹

2013

Journal of Cardiovascular Nursing

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Implantable cardioverter defibrillators (ICDs) have been the treatment of choice for those who experienced or are at risk of sudden cardiac arrest. Many patients who receive these devices experience progressive comorbid and cardiac conditions and may not want the additional survival provided by an ICD. Clinicians will need to counsel patients and families about advanced directives when their ICD is no longer beneficial, to prevent unnecessary suffering near the end of life. The Attitude Towards Advanced Directive Survey was developed to assess patients' level of knowledge and identify the barriers that prevent them from completing advanced directives. This will help clinicians promote completion of advanced directives by addressing barriers and increasing knowledge of them. The purpose of this study was to develop and evaluate the psychometric properties of the survey and investigate reliability and validity from its use among ICD patients. A convenience sample of 200 patients who have an ICD participated in this study. Psychometric testing of the Attitude Towards Advanced Directive Survey provided evidence to support the validity and reliability of the survey. Moderate to strong factor intercorrelations and conceptual meaningfulness led to the combination of 5 factors. The 5 factors were as follows: factor 1: communication barriers; factor 2: informed confidence; factor 3: timing of discussion; factor 4: patient-family relationship; and factor 5: patient-provider relationship. Reliability coefficient α ranged from .67 to .95 for the factors and .75 for the total scale. Stability reliability of the survey was analyzed through test-retest of the survey, with a response rate of 34% (n = 68), and revealed a significant positive correlation (r = .62; P < .001) between the first and second testing. The participants reported communication barriers and demonstrated poor understanding of their medical condition/treatments and were not comfortable discussing advanced directives with their families. They preferred to discuss advanced directives when they were first diagnosed and at every office visit because they felt more comfortable discussing advanced directives with their healthcare provider. This survey has the potential to be used in clinical practice and future research.

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A literature review: Advance directives and patients with implantable cardioverter defibrillators

Abstract: Implementation of advanced directives in patients' medical care will need to be encouraged in the event of illness. Advanced practice nurses can provide clear explanations of patients' treatment choices in outpatient and inpatient settings.

Cited by 6 publications

References 19 publications

How Should End-of-Life Advance Care Planning Discussions Be Implemented According to Patients and Informal Carers? A Qualitative Review of Reviews

How Should End-of-Life Advance Care Planning Discussions Be Implemented According to Patients and Informal Carers? A Qualitative Review of Reviews

Critical Appraisal Topic on Patient Education on Advance Directives in End-of-Life Care

The Development, Refinement, and Psychometric Testing of the Attitude Toward Advanced Directive Survey in Implantable Cardioverter Defibrillator Patients

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