The Role Complexities in Advance Care Planning for End-of-Life Care—Nursing Students’ Perception of the Nursing Profession

Abstract

Nurses’ perceptions of being responsible for advance care planning (ACP) vary greatly across different studies. It could, however, affect their involvement in advance care planning and patients’ quality of death. Recent studies on this topic have mostly focused on advance directives but not ACP and nurses in the ward setting. This study aimed to assess the perception of Hong Kong nursing undergraduates of the nurse’s role in advance care planning and examine its associations with knowledge, attitude, and experience. A cross-sectional 57-item survey was delivered to nursing undergraduates between June and August 2020. The chi-squared test or Fisher’s exact test were used for univariate analysis. The multiple logistic regression model was used for multivariate analysis. A total of 469 participants were assessed for eligibility; 242 of them were included in the data analysis, with a response rate of 97.6%. The majority of respondents—77.3% (95% CI: 72.0–82.6%)—perceived having a role in ACP, but large discrepancies were found between their perception of their role regarding different aspects of ACP. Participants who had a better knowledge status (p = 0.029) or supported the use of ACP (p < 0.001) were more likely to have a positive perception of their role in ACP. A negative correlation was found between the experience of life threat and positive role perception (p < 0.001). Through strengthening training, the role clarity of nursing undergraduates could be achieved, maximizing their cooperation with and implementation of ACP in their future nursing career. The enhancement of end-of-life education could also be undertaken to fill nursing undergraduates’ knowledge gap in this area and change their attitudes.

Implementing advance care planning in palliative and end of life care: a scoping review of community nursing perspectives

“…Overall, a lack of public awareness of the focus of ACP on quality of life as people move towards the end of life and the benefits that accrue from ACP was evident [ 49 ]. As Khairuddin et al [ 6 ] and Ng and Wong [ 80 ] have already indicated, low levels of awareness influence ACP avoidance.…”

Caregivers’ Experience of End-of-Life Stage Elderly Patients: Longitudinal Qualitative Interview

“…Emotional support and reinforcement from healthcare professionals’ are essential to enable caregivers to detach from their caregiving responsibility and heighten their bonding with the patients on a spiritual level. In addition to the healthcare workers, enhancement of the medical and nursing curriculum is important to build a caring culture and empathetic communication in healthcare [ 40 , 41 ]. This can reduce the psychological impact by shifting from tangible care to intangible care stages between caregiver and family members.…”

Exploring the Role of Nurses in Advance Care Planning Within Long-Term Care Homes: A Qualitative Study

“…Although nurses have a crucial role in care provided in LTCHs, there is a paucity of literature exploring their perceptions and experience in respect to their role in engaging in ACP ( Gilissen et al, 2017 ; Li-Shan et al, 2015 ; Ng & Wong, 2021 ). It was generally found that LTCH nurses were unclear about their role in ACP and also felt families did not completely understand the nurses’ role ( Beck et al, 2017 ; Handley et al, 2014 ; van Soest-Poortvliet et al, 2015 ).…”