[논문]Barriers to Effective Communication about Advance Care Planning and Palliative Care: A Qualitative Study

Hyosin Kim; Signe Peterson Flieger

doi:10.14475/jhpc.2023.26.2.42

Barriers to Effective Communication about Advance Care Planning and Palliative Care: A Qualitative Study 원문보기

Journal of hospice and palliative care, v.26 no.2, 2023년, pp.42 - 50

Hyosin Kim (College of Public Health & Human Sciences, Oregon State University) , Signe Peterson Flieger (Tufts Center for Health Systems and Policy Department of Public Health and Community Medicine, Tufts University School of Medicine)

Abstract ▼ AI-Helper

Purpose: The purpose of this study was to identify barriers to effective conversations about advance care planning (ACP) and palliative care reported by health care and community-based service providers in Massachusetts, USA. Methods: This qualitative research analyzed open-ended responses to two survey questions, inquiring about perceived barriers to having conversations about ACP and palliative care with patients and consumers. Data were collected between November 2017 and June 2019 from nine organizations in Massachusetts, including health care provider organizations, health insurers, community-based organizations, and a nursing education institution. Two researchers reviewed and coded the responses and identified common themes inductively. Results: Across 142 responses, primary barriers to ACP included hesitation and lack of understanding and knowledge, discomfort and resistance among service providers, lack of staff knowledge, difficulties with followup, and differences in ACP policies across regions. Common barriers to palliative care were misconceptions about palliative care and lack of knowledge, service providers' lack of preparedness, and limited policy support and availability. Challenges relevant to both ACP and palliative care were fear and discomfort around serious illness discussions, lack of knowledge and awareness, discussions that occur too late, and cultural and language barriers. Conclusion: Health care practitioners and community-based professionals reported consumer-, service provider-, and system-level barriers to facilitating conversations about ACP and palliative care with patients experiencing serious illness. There is a need for more tools and support to strengthen service providers' ACP and palliative care competencies and to promote a structured approach to health care planning conversations.

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참고문헌 (28)

1 Lovell A Yates P 2014 Advance care planning in palliative care: a systematic literature review of the contextual factors influencing its uptake 2008-2012 Palliat Med 28 1026 35 10.1177/0269216314531313 24821708

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2 Khandelwal N Benkeser DC Coe NB Curtis JR 2016 Potential influence of advance care planning and palliative care consultation on ICU costs for patients with chronic and serious illness Crit Care Med 44 1474 81 10.1097/CCM.0000000000001675 26974546

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3 Sudore RL Lum HD You JJ Hanson LC Meier DE Pantilat SZ 2017 Defining advance care planning for adults: A consensus definition from a multidisciplinary delphi panel J Pain Symptom Manage 53 821 32.e1 10.1016/j.jpainsymman.2016.12.331 28062339

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4 What is palliative care? 2022 [Internet] Center to Advance Palliative Care New York, NY Available from: https://www.capc.org/about/palliative-care/ . cited 2022 Oct 25
5 What are palliative care and hospice care? 2022 [Internet] National Institute on Aging Maryland Available from: https://www.nia.nih.gov/health/what-are-palliative-care-and-hospice-care . cited 2022 Oct 25
6 Detering KM Hancock AD Reade MC Silvester W 2010 The impact of advance care planning on end of life care in elderly patients: randomised controlled trial BMJ 340 c1345 10.1136/bmj.c1345 20332506

상세보기
7 Hanson LC Usher B Spragens L Bernard S 2008 Clinical and economic impact of palliative care consultation J Pain Symptom Manage 35 340 6 10.1016/j.jpainsymman.2007.06.008 18261877

상세보기
8 Morrison RS Penrod JD Cassel JB Caust-Ellenbogen M Litke A Spragens L 2008 Cost savings associated with US hospital palliative care consultation programs Arch Intern Med 168 1783 90 10.1001/archinte.168.16.1783 18779466

상세보기
9 Wright AA Zhang B Ray A Mack JW Trice E Balboni T 2008 Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment JAMA 300 1665 73 10.1001/jama.300.14.1665 18840840

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10 Zwakman M Jabbarian LJ van Delden J van der Heide A Korfage IJ Pollock K 2018 Advance care planning: a systematic review about experiences of patients with a life-threatening or life-limiting illness Palliat Med 32 1305 21 10.1177/0269216318784474 29956558

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11 Canter B Burack O Reinhardt J Mak W Weerahandi H Canter B 2021 Goals of care during the COVID-19 pandemic: implementing DNI, DNR, and DNH orders in a skilled nursing facility J Am Med Dir Assoc 22 B21 10.1016/j.jamda.2021.01.048 34287168

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12 Curtis JR Kross EK Stapleton RD 2020 The importance of addressing advance care planning and decisions about do-not-resuscitate orders during novel Coronavirus 2019 (COVID-19) JAMA 323 1771 2 10.1001/jama.2020.4894 32219360
13 Morrison RS Meier DE 2019 America's care of serious illness: a state-by state report card on access to palliative care in our nation's hospitals [Internet] Center to Advance Palliative Care; National Palliative Care Research Center New York, NY Available from: https://reportcard.capc.org/wp-content/uploads/2020/05/CAPC_State-by-State-Report-Card_051120.pdf . cited 2022 Oct 21
14 2022 Resources [Internet] Honoring Choices Massachusetts Lincoln, MA Available from: https://www.honoringchoicesmass.com/resources/ . cited 2022 Oct 26
15 2022 Home [Internet] Honoring Choices Massachusetts Lincoln, MA Available from: https://www.honoringchoicesmass.com . cited 2022 Oct 26
16 c2019 Serious illness care [Internet] Advance Palliative Care New York, NY Available from: https://www.ariadnelabs.org/serious-illness-care/ . updated 2020 May; cited 2022 Oct 26
17 c2015 Serious illness conversation guide [Internet] Ariadne Labs Boston, MA Available from: https://www.ariadnelabs.org/wp-content/uploads/2017/05/SI-CG-2017-04-21_FINAL.pdf . updated 2017 Apr 18; cited 2022 Oct 26
18 2019 2019 State-by-state report card on access to palliative care in our nation's hospitals [Internet] Center to Advance Palliative Care New York, NY Available from: https://reportcard.capc.org/state/massachusetts . cited 2022 Oct 26
19 Massachusetts Coalition for Serious Illness Care c2018 Massachusetts survey on advance care planning and serious illness care: Spring 2018 survey of Massachusetts residents Massachusetts Coalition for Serious Illness Care Boston 10.1001/jama.2020.4894
20 Kim H Sudhakar H Flieger S c2021 A mixed methods case study examining the impact and implementation of a structured approach to advance care planning in Massachusetts [Internet]. APHA 2021 Annual Meeting and Expo; 2021 Oct 22 American Public Health Association Denver, USA. Washington, DC Available from: https://apha.confex.com/apha/2021/meetingapp.cgi/Session/63006 . cited 2022 Oct 26
21 Bradley EH Curry LA Devers KJ 2007 Qualitative data analysis for health services research: developing taxonomy, themes, and theory Health Serv Res 42 1758 72 10.1111/j.1475-6773.2006.00684.x 17286625

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22 Glaser BG Strauss AL 1967 Discovery of grounded theory: Strategies for qualitative research Aldine De Gruyter New York 10.1097/00006199-196807000-00014
23 2017 Consumer-driven health care [Internet] Elsevier Applied Science; Elsevier Science Pub. Co. Essex, England, New York, NY Available from: https://www.sciencedirect.com/topics/medicine-and-dentistry/consumer-driven-health-care . cited 2022 Oct 26
24 2022 5 Things to talk about a conversation guide series for consumers and care providers [Internet] Honoring Choices Massachusetts Lincoln, MA Available from: https://www.honoringchoicesmass.com/conversation-guides-series . cited 2022 Oct 26
25 Krakauer EL Crenner C Fox K 2002 Barriers to optimum end-of-life care for minority patients J Am Geriatr Soc 50 182 90 10.1046/j.1532-5415.2002.50027.x 12028266

상세보기
26 McDermott E Selman LE 2018 Cultural factors influencing advance care planning in progressive, incurable disease: a systematic review with narrative synthesis J Pain Symptom Manage 56 613 36 10.1016/j.jpainsymman.2018.07.006 30025936

상세보기
27 Betancourt JR Green AR Carrillo JE Ananeh-Firempong O 2nd 2003 Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care Public Health Rep 118 293 302 10.1016/S0033-3549(04)50253-4 12815076

상세보기
28 Peters C Kim O Udow-Phillips M 2016 Using community input to improve advance care planning [Internet] Health Affairs Washington, DC Available from: https://www.healthaffairs.org/do/10.1377/forefront.20160822.056209 . cited 2022 Oct 26

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Barriers to Effective Communication about Advance Care Planning and Palliative Care: A Qualitative Study 원문보기

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