Initiating advance care planning on end-of-life issues in dementia: Ambiguity among UK and Dutch physicians

Steen, Jenny T. van der; Galway, Karen; Carter, Gillian; Brazil, Kevin

doi:10.1016/j.archger.2016.04.005

Cited by 30 publications

(37 citation statements)

References 20 publications

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“…53 One study compared UK GPs with Netherlands specialist Nursing Home physicians. 54 All studies used a descriptive design. The quality was variable: qualitative studies rated between moderate to high; 36 37 39 , poor to high for cross-sectional studies; 41 43 44 51 54 and moderate to high for cohort studies.…”

Section: Advance Care Planningmentioning

confidence: 99%

“…46 There was disagreement among GPs about introducing ACP at the time of diagnosis of dementia, compared with after that time. 54 Several factors that influenced the GPs' completion of ACP were identified. An ACP was more likely to be completed if the GP was older and had more clinical experience; 51 if the GP was comfortable discussing ACP; 42 51 52 if they had appropriate education and training in ACP; 36 37 40 45 46 if the GP was involved and trained in palliative care; 52 and if they considered it their responsibility to raise the issue.…”

Section: Advance Care Planningmentioning

confidence: 99%

“…An ACP was more likely to be completed if the GP was older and had more clinical experience; 51 if the GP was comfortable discussing ACP; 42 51 52 if they had appropriate education and training in ACP; 36 37 40 45 46 if the GP was involved and trained in palliative care; 52 and if they considered it their responsibility to raise the issue. 54 The quality of ACP was variable. Where EoL discussions took place, not all holistic aspects, such as spiritual and existential concerns, social issues and cultural differences, were discussed.…”

Section: Advance Care Planningmentioning

confidence: 99%

See 2 more Smart Citations

General practice palliative care: patient and carer expectations, advance care plans and place of death—a systematic review

Johnson

McVey

Rhee

et al. 2018

BMJ Support Palliat Care

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Section: Advance Care Planningmentioning

confidence: 99%

Section: Advance Care Planningmentioning

confidence: 99%

Section: Advance Care Planningmentioning

confidence: 99%

See 1 more Smart Citation

General practice palliative care: patient and carer expectations, advance care plans and place of death—a systematic review

Johnson

McVey

Rhee

et al. 2018

BMJ Support Palliat Care

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show abstract

“…Having a physician [27,53] or, more specifically, a GP [40] improved the likelihood of ACP initiation among PwD. This facilitating factor may come from the fact that GPs tended to build up long-term relationships with PwD, thus making them more open to discussing ACP.…”

Section: Facilitatorsmentioning

confidence: 99%

A narrative review of facilitating and inhibiting factors in advance care planning initiation in people with dementia

et al. 2020

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Aim To identify and assess factors that affect the decisions to initiate advance care planning (ACP) amongst people living with dementia (PwD). Findings All articles included for the analysis came from countries that have supportive regulations and guidelines for ACP. ACP initiation amongst PwD is a complex decision that involves several stakeholders who have different knowledge and attitudes of ACP. Message More research is required on ACP education, initiation timing given the disease trajectory, and changing family dynamics overtime.

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“…Possible differences in perceptions need further study. Furthermore, although 93.5 physicians care for five or more dying patients in a year, 29 the last resident may, for some physicians, have been a long time ago and the response less precise. Although the structure of care provision in nursing homes differs between countries, our findings may be relevant for multidisciplinary teams involved in the care of nursing home residents outside the Netherlands.…”

Section: Limitations Of Studymentioning

confidence: 99%

Spiritual care provided by nursing home physicians: a nationwide survey

Gijsberts

Steen

Hertogh

et al. 2019

BMJ Support Palliat Care

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Objective To examine perceptions and experiences regarding providing spiritual care at the end of life of elderly care physicians practising in nursing homes in the Netherlands, and factors associated with spiritual care provision. Methods A cross-sectional survey was sent to a representative sample of 642 elderly care physicians requesting information about their last patient who died and the spiritual care they provided. We compared their general perception of spiritual care with spiritual and other items abstracted from the literature and variables associated with the physicians' provision of spiritual care. Self-reported reasons for providing spiritual care were analysed with qualitative content analysis. results The response rate was 47.2%. Almost half (48.4%) provided spiritual end-of-life care to the last resident they cared for. Half (51.8%) identified all 15 spiritual items, but 95.4% also included psychosocial items in their perception of spirituality and 49.1% included other items. Physicians who included more non-spiritual items reported more often that they provided spiritual care, as did more religious physicians and those with additional training in palliative care. Reasons for providing spiritual care included a request by the resident or the relatives, resident's religiousness, fear of dying and involvement of a healthcare chaplain. conclusion Most physicians perceived spirituality as a broad concept and this increased self-reported spiritual caregiving. Religious physicians and those trained in palliative care may experience fewer barriers to providing spiritual care. Additional training in reflecting upon the physician's own perception of spirituality and training in multidisciplinary spiritual caregiving may contribute to the quality of end-of-life care for nursing home residents.on July 5, 2020 by guest. Protected by copyright.

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Initiating advance care planning on end-of-life issues in dementia: Ambiguity among UK and Dutch physicians

Cited by 30 publications

References 20 publications

General practice palliative care: patient and carer expectations, advance care plans and place of death—a systematic review

General practice palliative care: patient and carer expectations, advance care plans and place of death—a systematic review

A narrative review of facilitating and inhibiting factors in advance care planning initiation in people with dementia

Spiritual care provided by nursing home physicians: a nationwide survey

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