Exploring the Uptake of Advance Care Planning in Older Adults: An Integrative Review.
Advance care planning
communication
conceptual model
older adults
patient- and family-centered
Journal
Journal of pain and symptom management
ISSN: 1873-6513
Titre abrégé: J Pain Symptom Manage
Pays: United States
ID NLM: 8605836
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
16
04
2019
revised:
24
06
2020
accepted:
26
06
2020
pubmed:
10
7
2020
medline:
24
6
2021
entrez:
10
7
2020
Statut:
ppublish
Résumé
Advance care planning (ACP) is essential to elicit goals, values, and preferences of care in older adults with serious illness and on trajectories of frailty. An exploration of ACP uptake in older adults may identify barriers and facilitators. To conduct an integrative review of research on the uptake of ACP in older adults and create a conceptual model of the findings. Using Whittemore and Knafl's methodology, we systematically searched four electronic databases of ACP literature in older adults from 1996 through December 2019. Critical appraisal tools were used to assess study quality, and articles were categorized according to level of evidence. Statistical and thematic analysis was then undertaken. Among 1081 studies, 78 met inclusion criteria. Statistical analysis evaluated ACP and variables within the domains of demographics, psychosocial, disability and functioning, and miscellaneous. Thematic analysis identified a central category of enhanced communication, followed by categories of 1) provider role and preparation; 2) patient/family relationship patterns; 3) standardized processes and structured approaches; 4) contextual influences; and 5) missed opportunities. A conceptual model depicted categories and relationships. Enhanced communication and ACP facilitators improve uptake of ACP. Clinicians should be cognizant of these factors. This review provides a guide for clinicians who are considering implementation strategies to facilitate ACP in real-world settings.
Identifiants
pubmed: 32645455
pii: S0885-3924(20)30588-1
doi: 10.1016/j.jpainsymman.2020.06.043
pmc: PMC7342022
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1208-1222.e59Informations de copyright
Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.
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