Advanced care planning: A study on home health nurses

Knowledge, Attitudes, and Practice Behaviors of Oncology Advanced Practice Nurses Regarding Advanced Care Planning for Patients With Cancer

“…Oncology APN respondents in the current study also demonstrated fairly positive attitudes toward advanced care planning. They felt comfortable discussing advanced care planning and related issues with patients and families, similar to the results found among general NPs and RNs (Badzek et al, 2006;Cramer et al, 2003;Lipson et al, 2004;Schlegel & Shannon, 2000;Tyree, Long, & Greenberg, 2005). On the other hand, physicians appeared to be less comfortable discussing endof-life care issues with patients and families (Bradley et al, 2002).…”

“…Other investigators found that RNs, including oncology nurses, had low or limited knowledge about hospice and advanced care planning (Badzek et al, 2006;Cramer et al, 2003, Jezewski, Brown, et al, 2005. Physicians' knowledge regarding end-of-life care and advanced care planning were found to be similar to that of the oncology APNs in the current survey, with about 50%-75% of physicians rating themselves knowledgeable (Bradley et al, 2002).…”

“…Many clinicians had biased views about advance directives, and some perceived that patients and family members were reluctant to discuss these care issues. In addition, insufficient knowledge exists among clinicians regarding advance directives and end-of-life or hospice care, and most felt inadequately trained to deliver news, such as a cancer diagnosis or prognosis and recommending end-of-life care options (Badzek et al, 2006;Bradley et al, 2002;Cramer, McCorkle, Cherlin, JohnsonHurzeler, & Bradley, 2003;Duke & Thompson, 2007;Feeg & Elebiary, 2005;Jezewski, Brown, et al, 2005;Jezewski, Meeker, & Robillard, 2005;Lipson, Hausman, Higgins, & Burant, 2004;Morrison, Morrison, & Glickman, 1994;Scherer, Jezewski, Graves, Wu, & Bu, 2006).…”

Advance Directives

“…8 According to a study conducted in 4 states to measure knowledge, attitudes, and experiences of oncology nurses in end-of-life care, environments need to change to provide more autonomy and support to nurses to facilitate an atmosphere that promotes a team approach to topics related to end-oflife care. 9 A study of home health nurses also demonstrated that nurses perceived them-selves as more knowledgeable regarding advance directives than they really were. 10 An exploratory, descriptive study of acute care nurses in a faith-based community hospital found that only slightly more than one-half of 133 nurses responding had sufficient information and were comfortable discussing advance directives.…”

“…1 Although nurses often have said they were comfortable discussing advance directives, the literature reflects inconsistencies between perceived comfort and actual practice. 5,9,11,12 Studies have found that nurses identify the benefits of advance directives and have positive attitudes but lack knowledge and confidence to effectively discuss end-of-life issues with patients and families. 2,[6][7][8]13 The literature related to nurses' attitudes about advance directives points to an unmet need for increased knowledge and confidence to address barriers and ethical dilemmas in end-of-life care.…”