Advance care planning engagement in patients with chronic, life-limiting illness: baseline findings from a cluster-randomised controlled trial in primary care.
advance care planning
baseline survey
chronic disease
general practice
patient participation
surveys and questionnaires
Journal
The British journal of general practice : the journal of the Royal College of General Practitioners
ISSN: 1478-5242
Titre abrégé: Br J Gen Pract
Pays: England
ID NLM: 9005323
Informations de publication
Date de publication:
05 2023
05 2023
Historique:
received:
22
02
2022
accepted:
03
10
2022
medline:
1
5
2023
pubmed:
4
4
2023
entrez:
3
4
2023
Statut:
epublish
Résumé
Advance care planning (ACP) has been characterised as a complex process of communication and decision making. For ACP behaviour change, underlying processes such as self-efficacy and readiness are needed. However, studies about which patient characteristics are associated with ACP have mainly focused on whether ACP actions are completed, leaving behaviour change processes unexplored. To assess whether patients' characteristics and patient-perceived quality of GP ACP communication were associated with patients' ACP engagement. Baseline data were used from the ACP-GP cluster-randomised controlled trial in patients with chronic, life-limiting illness ( Patients completed questionnaires detailing demographic and clinical characteristics, and their perception about their GPs' ACP information provision and listening. Engagement was measured using the 15-item ACP Engagement Survey, with self-efficacy and readiness subscales. Linear mixed models tested associations with engagement. Demographic and clinical characteristics were not associated with engagement; nor was how much ACP information patients received from their GP or the extent to which the GP listened to what was important for the patient to live well or important to the patient regarding future care. Higher overall ACP engagement ( This study suggests that GPs providing information about ACP alone is not associated with a patient's ACP engagement; an important element is to listen to patients' worries regarding their future health.
Sections du résumé
BACKGROUND
Advance care planning (ACP) has been characterised as a complex process of communication and decision making. For ACP behaviour change, underlying processes such as self-efficacy and readiness are needed. However, studies about which patient characteristics are associated with ACP have mainly focused on whether ACP actions are completed, leaving behaviour change processes unexplored.
AIM
To assess whether patients' characteristics and patient-perceived quality of GP ACP communication were associated with patients' ACP engagement.
DESIGN AND SETTING
Baseline data were used from the ACP-GP cluster-randomised controlled trial in patients with chronic, life-limiting illness (
METHOD
Patients completed questionnaires detailing demographic and clinical characteristics, and their perception about their GPs' ACP information provision and listening. Engagement was measured using the 15-item ACP Engagement Survey, with self-efficacy and readiness subscales. Linear mixed models tested associations with engagement.
RESULTS
Demographic and clinical characteristics were not associated with engagement; nor was how much ACP information patients received from their GP or the extent to which the GP listened to what was important for the patient to live well or important to the patient regarding future care. Higher overall ACP engagement (
CONCLUSION
This study suggests that GPs providing information about ACP alone is not associated with a patient's ACP engagement; an important element is to listen to patients' worries regarding their future health.
Identifiants
pubmed: 37012079
pii: BJGP.2022.0100
doi: 10.3399/BJGP.2022.0100
pmc: PMC10098835
doi:
Types de publication
Randomized Controlled Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e384-e391Informations de copyright
© The Authors.
Références
Arch Intern Med. 2006 May 22;166(10):1092-7
pubmed: 16717171
Med Care. 1996 Mar;34(3):220-33
pubmed: 8628042
BMJ Support Palliat Care. 2015 Mar;5(1):40-7
pubmed: 24644188
J Pain Symptom Manage. 2017 Apr;53(4):669-681.e8
pubmed: 28042072
Lancet Oncol. 2017 Sep;18(9):e543-e551
pubmed: 28884703
Scand J Prim Health Care. 2013 Dec;31(4):215-26
pubmed: 24299046
Am J Hosp Palliat Care. 2010 Aug;27(5):306-12
pubmed: 20103783
BMJ Support Palliat Care. 2015 Mar;5(1):54-62
pubmed: 24644192
Age Ageing. 2015 May;44(3):371-6
pubmed: 25917242
BMJ. 2006 Oct 28;333(7574):868-9
pubmed: 17068016
Can Fam Physician. 2018 May;64(5):371-377
pubmed: 29760260
J Palliat Med. 2013 Sep;16(9):1055-61
pubmed: 23767949
J Am Geriatr Soc. 2020 Nov;68(11):2638-2642
pubmed: 32783199
Palliat Med. 2011 Sep;25(6):613-29
pubmed: 21273221
BMJ Support Palliat Care. 2021 Mar;11(1):89-91
pubmed: 32414786
J Pain Symptom Manage. 2018 Sep;56(3):436-459.e25
pubmed: 29807158
Fam Pract. 2018 Jul 23;35(4):495-502
pubmed: 29272418
CMAJ. 2006 Feb 28;174(5):627-33
pubmed: 16505458
Palliat Med. 2018 Sep;32(8):1305-1321
pubmed: 29956558
J Pain Symptom Manage. 2019 Jan;57(1):118-139.e6
pubmed: 30595148
Australas J Ageing. 2021 Jun;40(2):162-167
pubmed: 33159414
J Pain Symptom Manage. 2013 Sep;46(3):355-65
pubmed: 23200188
Patient Educ Couns. 2012 Jan;86(1):25-32
pubmed: 21741194
BMC Palliat Care. 2015 Dec 07;14:71
pubmed: 26643482
J Am Geriatr Soc. 2008 Jun;56(6):1006-13
pubmed: 18410324
Clin Med (Lond). 2009 Feb;9(1):76-9
pubmed: 19271609
Dig Dis Sci. 2021 May;66(5):1446-1451
pubmed: 32500286
BMJ Open. 2019 Sep 18;9(9):e030275
pubmed: 31537570
BMJ Support Palliat Care. 2020 Jun 8;:
pubmed: 32513679
J Am Geriatr Soc. 2009 Jan;57(1):31-9
pubmed: 19170789
BMC Fam Pract. 2020 May 25;21(1):94
pubmed: 32450812
J Am Geriatr Soc. 2002 Mar;50(3):496-500
pubmed: 11943046
J Am Med Dir Assoc. 2019 Mar;20(3):227-248
pubmed: 30471947
BMC Med Res Methodol. 2021 Sep 25;21(1):194
pubmed: 34563115
J Palliat Med. 2019 Aug;22(8):902-907
pubmed: 30715999
J Pain Symptom Manage. 2019 Nov;58(5):857-863.e1
pubmed: 31349036
Palliat Med. 2021 Jun;35(6):1137-1147
pubmed: 33934669
BMJ Support Palliat Care. 2022 Jul;12(e2):e236-e247
pubmed: 32341055
Med J Aust. 2013 Nov 18;199(10):662-6
pubmed: 24237095
PLoS One. 2013 Sep 05;8(9):e72465
pubmed: 24039772
Br J Gen Pract. 2008 Jan;58(546):32-6
pubmed: 18186994
Assessment. 2021 Oct;28(7):1785-1798
pubmed: 32864983
Eur Geriatr Med. 2022 Feb;13(1):285-289
pubmed: 34826110
Palliat Support Care. 2010 Sep;8(3):267-75
pubmed: 20875170
Eur J Cancer Care (Engl). 2019 May;28(3):e13091
pubmed: 31074187
BMC Palliat Care. 2016 Feb 11;15:17
pubmed: 26868650
J Pain Symptom Manage. 2011 Oct;42(4):565-77
pubmed: 21530152
J Gen Intern Med. 2012 Apr;27(4):445-51
pubmed: 22038469
BMC Palliat Care. 2021 Jun 25;20(1):97
pubmed: 34172030
Br J Cancer. 2003 Mar 10;88(5):658-65
pubmed: 12618870