New horizons in advance care planning: narratives, identity and cultural humility.

Advance care planning (ACP) is considered important for patient-centred care in serious illness, yet evidence it benefits patients is inconsistent. This reflects a lack of clarity over how ACP interventions are supposed to achieve their intended goals and what these goals should be, leading to varia...

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Publicado en:Age & Ageing Vol. 55; no. 6; pp. 1 - 11
Autores principales: Hopkins, Sarah A, Polak, Louisa, Hoare, Sarah E, Etkind, Simon N, Stalley, Luke, Lovick, Roberta, Kuhn, Isla, Simpson, Rhian, Harwood, Rowan H, Barclay, Stephen
Formato: Artículo
Publicado: Oxford University Press / USA Jun2026
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2026
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        10.1093/ageing/afag191
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        atl: New horizons in advance care planning: narratives, identity and cultural humility.
      aug:
        au:
          Hopkins, Sarah A
          Polak, Louisa
          Hoare, Sarah E
          Etkind, Simon N
          Stalley, Luke
          Lovick, Roberta
          Kuhn, Isla
          Simpson, Rhian
          Harwood, Rowan H
          Barclay, Stephen
        affil:
          Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
          Department of Public Health and Primary Care, University of Cambridge, Cambridge, UKCambridge University Hospitals NHS Foundation Trust, Cambridge, UK
          Department of Sociology, University of Zurich, Zürich, ZH, Switzerland
          Patient representative, Great Yarmouth, UK
          Cambridge University Medical Library, School of Clinical Medicine, University of Cambridge, Cambridge, UK
          School of Health Sciences, Queens Medical Centre, University of Nottingham, Nottingham,  UK
      su:
        Cultural awareness
        Group identity
        Occupational roles
        Psychological well-being
        Attitude (Psychology)
        Patient-centered care
        Patient-professional relations
        Terminal care
        Advance directives (Medical care)
        Old age
        Patient autonomy
      sug:
        subj:
          Cultural awareness
          Group identity
          Occupational roles
          Psychological well-being
          Attitude (Psychology)
          Patient-centered care
          Patient-professional relations
          Terminal care
          Advance directives (Medical care)
          Old age
          Patient autonomy
      keyword:
        ACP
        advance care planning
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        culture
        https://dx.doi.org/10.1093/ageing/afag191
        identity
        inLanguage:en
        narrative
        older people
        publisher:Oxford University Press
        sameAs:https://pubmed.ncbi.nlm.nih.gov/42381391/
        ACP
        advance care planning
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        culture
        https://dx.doi.org/10.1093/ageing/afag191
        identity
        inLanguage:en
        narrative
        older people
        publisher:Oxford University Press
        sameAs:https://pubmed.ncbi.nlm.nih.gov/42381391/
      ab: Advance care planning (ACP) is considered important for patient-centred care in serious illness, yet evidence it benefits patients is inconsistent. This reflects a lack of clarity over how ACP interventions are supposed to achieve their intended goals and what these goals should be, leading to variation in implementation. This article seeks to address this knowledge gap by focusing on the role of narratives. Although ACP draws on patients' illness narratives (their personal stories of illness, including hopes and fears), the role of these narratives is often unacknowledged. We systematically reviewed the evidence on narratives and ACP and synthesised the findings with broader multidisciplinary literature. Attending to patient narratives can be a route to achieving many goals of ACP (including preserving patient autonomy, strengthening relationships and preparing for end-of-life) and can help patients to maintain their identity, which is important for well-being but is disrupted by illness and frailty. The values underpinning ACP are culturally-specific, however, with less relevance for some patients: better appreciation of this is a step towards cultural humility and more equitable care. The role of clinicians in contributing to patient life narratives through ACP is controversial. Some argue that clinicians should shape their patient's narrative, helping them to make meaning at the end-of-life, while others have problematised expectations that patients tell, and clinicians facilitate, 'good death' stories. Synthesising existing knowledge provides clinicians with insights on how to approach end-of-life conversations through framing discussions around patient narratives and lays the foundations for future research exploring narrative approaches to ACP.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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