Patient and caregiver perspectives on early identification for advance care planning in primary healthcare settings.
Background: As part of a broader study to improve the capacity for advance care planning (ACP) in primary healthcare settings, the research team set out to develop and validate a computerized algorithm to help primary care physicians identify individuals at risk of death, and also carried out focus...
| Publicado en: | BMC Family Practice Vol. 21; no. 1; pp. 1 - 10 |
|---|---|
| Autores principales: | , , , , , |
| Formato: | research Journal Article |
| Publicado: |
BioMed Central
7/9/2020
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=144473092&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 144473092 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14712296 1CHN jtl: BMC Family Practice issn: 14712296 maglogo: N pubinfo: dt: 7/9/2020 vid: 21 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 144473092 144473092 144473092 10.1186/s12875-020-01206-w 144473092 ppf: 1 ppct: 9 formats: tig: atl: Patient and caregiver perspectives on early identification for advance care planning in primary healthcare settings. aug: au: Kendell, Cynthia Kotecha, Jyoti Martin, Mary Han, Han Jorgensen, Margaret Urquhart, Robin affil: Cancer Outcomes Research Program, Department of Surgery, Dalhousie University and Nova Scotia Health Authority, Halifax, Nova Scotia, Canada sug: subj: Patient Attitudes Evaluation Caregiver Attitudes Evaluation Algorithms Risk Assessment Mortality Risk Factors Advance Care Planning Canada Primary Health Care Canada Palliative Care Canada Human Semi-Structured Interview Canada Aged Aged, 80 and Over Qualitative Studies Descriptive Research Analytic Research Physician's Role Electronic Health Records Appointments and Schedules Support, Psychosocial Aged: 65+ years Aged, 80 & over ab: Background: As part of a broader study to improve the capacity for advance care planning (ACP) in primary healthcare settings, the research team set out to develop and validate a computerized algorithm to help primary care physicians identify individuals at risk of death, and also carried out focus groups and interviews with relevant stakeholder groups. Interviews with patients and family caregivers were carried out in parallel to algorithm development and validation to examine (1) views on early identification of individuals at risk of deteriorating health or dying; (2) views on the use of a computerized algorithm for early identification; and (3) preferences and challenges for ACP. Methods: Fourteen participants were recruited from two Canadian provinces. Participants included individuals aged 65 and older with declining health and self-identified caregivers of individuals aged 65 and older with declining health. Semi-structured interviews were conducted via telephone. A qualitative descriptive analytic approach was employed, which focused on summarizing and describing the informational contents of the data. Results: Participants supported the early identification of patients at risk of deteriorating health or dying. Early identification was viewed as conducive to planning not only for death, but for the remainder of life. Participants were also supportive of the use of a computerized algorithm to assist with early identification, although limitations were recognized. While participants felt that having family physicians assume responsibility for early identification and ACP was appropriate, questions arose around feasibility, including whether family physicians have sufficient time for ACP. Preferences related to the content of and approach to ACP discussions were highly individualized. Required supports during ACP include informational and emotional supports. Conclusions: This work supports the role of primary care providers in the early identification of individuals at risk of deteriorating health or death and the process of ACP. To improve ACP capacity in primary healthcare settings, compensation systems for primary care providers should be adjusted to ensure appropriate compensation and to accommodate longer ACP appointments. Additional resources and more established links to community organizations and services will also be required to facilitate referrals to relevant community services as part of the ACP process. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|