Ervaringen van patiënten en zorgverleners met advance care planning

Summary

Advance Care Planning in practice: Experiences of patients and healthcare professionals
Marieke Zwakman

AIM: To obtain insight into the experiences of patients and healthcare professionals with Advance Care Planning (ACP) and develop suggestions to improve ACP.
METHOD: Two systematic reviews were performed. Furthermore, three studies, comprising two qualitative studies and one mixed-method study, were performed alongside of the ACTION trial.
FINDINGS: Patients who participated in ACP were ambivalent about ACP and mentioned that a degree of readiness and openness was needed. Healthcare professionals mentioned that conducting ACP conversations was a learning process. Mainly due to the fact that they experienced the ACP intervention as supportive as well as challenging. All patients expressed both signs of not being ready and of being ready within one ACP conversation. Patients described in their advance directive that ‘maintaining normal life’ and ‘experiencing meaningful relationships’ were important to live well. Fears and worries mainly concerned disease progression and patients hoped for prolongation of life.
CONCLUSION: It is recommended that ACP conversations are conducted by a healthcare professional who is involved in the regular care of the patient. Additionally, healthcare professionals should be sensitive to the readiness of the patient. Lastly, tools, training and support for healthcare professionals are required to bring out the best of ACP.

Keywords: Advance Care Planning, experiences, patients, healthcare professional