Advance care planning in medicare/medicaid-funded agencies: providing a training in cultural competence

Inoue, Megumi; Rinker, Cortney Hughes; Vargas-Jackson, Rebecca

doi:10.1080/02701960.2018.1554567

Cited by 2 publications

(1 citation statement)

References 12 publications

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“…At the same time, family members can prepare for the death and loss of patients, which decreases remorse and alleviates stress in family members due to making decisions when they do not know the patient's wishes. This also avoids doubts and conflicts between family members with differing opinions and protects them from accusations and attacks from other family members after the patient has died [25]. The interviews found that caregiving experience drives caregivers to think deeply about life dignity and EOL issues.…”

Section: Discussionmentioning

confidence: 94%

Does the Experience of Caring for a Severely Disabled Relative Impact Advance Care Planning? A Qualitative Study of Caregivers of Disabled Patients

Chiang

Hsieh

Fan

et al. 2020

IJERPH

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The aging of the Taiwanese population has become a major issue. Previous research has focused on the burden and stress faced by caregivers, but has not explored how the experience of these caregivers influences decisions of advance care planning (ACP). Semi-structured and in-depth interviews were conducted. Qualitative content analysis was used to identify important themes. Five themes and fourteen sub-themes were identified: (1) Past experiences: patient wishes, professional recommendations, and expectation about disease progress; (2) Impact of care on family members: positive affirmation, open-minded life, social isolation and health effects, and financial and life planning effects; (3) Attitude toward life: not forcing to stay, and not becoming a burden, (4) Expected proxy dilemmas: torment between doing or not, seeing the extension of suffering and toil, and remorse and self-blame; (5) Expectation of end of life (EOL) care: caregiver’s experience and EOL care decisions, and practicality of EOL decision making. After making multiple medical decisions for their disabled relatives, caregivers are able to calmly face their own medical decisions, and “not becoming a burden” is their primary consideration. It’s suggested that implementation of shared decision-making on medical care for patients with chronic disability will not only improve the quality of their medical care but also reduce the development of remorse and guilty feelings of caregivers after making medical decisions.

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Section: Discussionmentioning

confidence: 94%

Does the Experience of Caring for a Severely Disabled Relative Impact Advance Care Planning? A Qualitative Study of Caregivers of Disabled Patients

Chiang

Hsieh

Fan

et al. 2020

IJERPH

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Continuing Education Outcomes for Advance Care Planning: A Systematic Review of the Literature

Pearse

Saxon

Hyde

et al. 2021

J Contin Educ Health Prof

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Introduction: Advance care planning (ACP) is a process of considering future health and care needs for a time when a person may be unable to speak for themselves. Health professional continuing education programs have been proposed for facilitating patient participation in ACP; however, their impacts on participants, patient and clinical outcomes, and organizational approaches to ACP are not well understood. Methods: This systematic literature review examined interventional studies of education programs conducted with health professionals and care staff across a broad range of settings. Five electronic databases were searched up to June 2020, and a manual search of reference lists was conducted. The quality of studies was appraised by the first, second, and third authors. Results: Of the 7993 articles identified, 45 articles met the inclusion criteria. Program participants were predominantly medical, nursing, and social work staff, and students. Interventions were reported to improve participants' self-perceived confidence, knowledge, and skills; however, objectively measured improvements were limited. Multimodal programs that combined initial didactic teaching and role-play simulation tasks with additional activities were most effective in producing increased ACP activity in medical records. Evidence for improved clinical outcomes was limited. Discussion: Further studies that use rigorous methodological approaches would provide further evidence about what produces improved patient and clinical outcomes. Needs analyses and quality indicators could be considered to determine the most appropriate and effective education resources and monitor their impacts. The potential contribution of a broader range of health professionals and interprofessional learning approaches could be considered to ultimately improve patient care.

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Advance care planning in medicare/medicaid-funded agencies: providing a training in cultural competence

Cited by 2 publications

References 12 publications

Does the Experience of Caring for a Severely Disabled Relative Impact Advance Care Planning? A Qualitative Study of Caregivers of Disabled Patients

Does the Experience of Caring for a Severely Disabled Relative Impact Advance Care Planning? A Qualitative Study of Caregivers of Disabled Patients

Continuing Education Outcomes for Advance Care Planning: A Systematic Review of the Literature

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