Development of a Scale to Assess Physician Advance Care Planning Self-Efficacy

Baughman, Kristin R.; Ludwick, Ruth; Fischbein, Rebecca; McCormick, Kenelm F.; Meeker, James R.; Hewit, Mike; Drost, Jennifer; Kropp, Denise

doi:10.1177/1049909115625612

Cited by 26 publications

(32 citation statements)

References 20 publications

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“…The advanced care planning (ACP) process includes ongoing discussions among health-care providers, patients, and their families about disease pathways, treatment options, patient goals, values, and preferences. 1 The premise of ACP formulation is that patients have clear consciousness and obtain information about prognosis and ACP measures. The goal of ACP is to help patients get medical care that is consistent with their values, goals, and preferences during serious and chronic illnesses.…”

Section: Introductionmentioning

confidence: 99%

Investigation and Analysis of Undergraduate Nursing Students’ Attitudes Toward Advanced Care Planning and Their Willingness to Implement

Shi

Tang

et al. 2020

Am J Hosp Palliat Care

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Objective: The purpose of this study is to understand the attitude of undergraduate nursing students toward advanced care planning (ACP) and their willingness to implement ACP and to analyze its influencing factors, so as to provide evidence-based basis for life and death education and ACP-related training in colleges and universities. Methods: A total of 312 nursing undergraduates from a university in Chengdu (China) were surveyed by using general information questionnaire, attitude scale of ACP, and willingness questionnaire to implement ACP. Results: The scores of undergraduate nursing students’ attitude toward ACP were 24.97 ± 2.75, and the scores of total willingness to ACP were 79.26 ± 9.70. Univariate analysis and multivariate linear regression analysis showed that religious belief, grade, family relationship, and family discussion of death were the factors influencing the willingness of nursing students to carry out ACP. Conclusions: The attitude of undergraduate nursing students toward ACP tended to be positive, but their cognition of ACP was misunderstood, and their willingness to implement ACP needed to be improved. To improve the awareness and implementating willingness of undergraduate nursing students to ACP, it was recommended that colleges and universities carried out systematic standardized life and death education courses and ACP-related training.

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Section: Introductionmentioning

confidence: 99%

Investigation and Analysis of Undergraduate Nursing Students’ Attitudes Toward Advanced Care Planning and Their Willingness to Implement

Shi

Tang

et al. 2020

Am J Hosp Palliat Care

View full text Add to dashboard Cite

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“…Fourthly, we adapted, developed and preliminarily tested a survey to measure knowledge, selfefficacy, attitudes and practices ourselves. However, the self-efficacy scale from Baughman et al, published in 2016, showed high internal consistency and some evidence of convergent, known groups, and predictive validity in family physicians and might be used in the future for similar research, after being tested in this particular population [44]. In addition, responses of staff and volunteers of intervention groups may be affected by their knowledge of their allocation because blinding will not be possible.…”

Section: Discussionmentioning

confidence: 99%

Implementing the theory-based advance care planning ACP+ programme for nursing homes: study protocol for a cluster randomised controlled trial and process evaluation

et al. 2020

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Background: Research has highlighted the need for improving the implementation of advance care planning (ACP) in nursing homes. We developed a theory-based multicomponent ACP intervention (the ACP+ programme) aimed at supporting nursing home staff with the implementation of ACP into routine nursing home care. We describe here the protocol of a cluster randomised controlled trial (RCT) that aims to evaluate the effects of ACP+ on nursing home staff and volunteer level outcomes and its underlying processes of change. Methods: We will conduct a cluster RCT in Flanders, Belgium. Fourteen eligible nursing homes will be pair-matched and one from each pair will be randomised to either continue care and education as usual or to receive the ACP+ programme (a multicomponent programme which is delivered stepwise over an eight-month period with the help of an external trainer). Primary outcomes are: nursing home care staff's knowledge of, and self-efficacy regarding ACP. Secondary outcomes are: 1) nursing home care staff's attitudes towards ACP and ACP practices; 2) support staff's and volunteer's ACP practices and 3) support staff's and volunteers' self-efficacy. Measurements will be performed at baseline and eight months post-measurement, using structured self-reported questionnaires. A process evaluation will accompany the outcome evaluation in the intervention group, with measurements throughout and post-intervention to assess implementation, mechanisms of impact and context and will be carried out using a mixed-methods design. Discussion: There is little high-quality evidence regarding the effectiveness and underlying processes of change of ACP in nursing homes. This combined outcome and process evaluation of the ACP+ programme aims to contribute to building the necessary evidence to improve ACP and its uptake for nursing home residents and their family. Trial registration: The study is registered at ClinicalTrials.gov (no. NCT03521206). Registration date: May 10, 2018. Inclusion of nursing homes started March, 2018. Hence, the trial was retrospectively registered but before end of data collection and analyses.

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“…40 There is compelling evidence that knowing the person's treatment preferences could reduce the burden on surrogates, 41 prevent burdensome interventions of questionable benefit near end of life, 42 and reduce inappropriate hospital admissions and health-care costs for persons with cognitive impairment and dementia. 2,3 While some physicians prefer to discuss ACP when patients initiate the conversation, 26,43 lack of patient and family knowledge about ACP may prevent them from initiating the conversation. Education for patients and families about ACP within the context of dementia is an important role that PCCMCs can assume.…”

Section: Discussionmentioning

confidence: 99%

“…While some physicians prefer to discuss ACP when patients initiate the conversation, 26,43 lack of patient and family knowledge about ACP may prevent them from initiating the conversation. Education for patients and families about ACP within the context of dementia is an important role that PCCMCs can assume.…”

Section: Discussionmentioning

confidence: 99%

Advanced Care Planning for Persons With Dementia in Primary Care: Attitudes and Barriers Among Health-Care Professionals

et al. 2018

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Background: Advance care planning (ACP) provides clarity on goals and preferences for future health-care decisions, the timeliness of which is critical for persons with dementia. Aim: This study assessed Primary Care Collaborative Memory Clinic (PCCMC) health-care practitioners’ desire for more education on ACP, capacity for and attitudes toward ACP, and current ACP practices in their regular family practice and in their PCCMC. Methods: Primary Care Collaborative Memory Clinic health-care professionals completed a questionnaire in which they rated their interest in learning various ACP-related topics (5-point scale: not at all to very much so), attitudes toward ACP, and the importance of and perceived degree of responsibility for ACP (5-point scale: not at all to extremely). Respondents estimated ACP completion in regular family practice and PCCMC. Results: Two hundred and sixty one surveys were completed. Mean knowledge ratings were moderate (M = 3.0) and mean ratings of interest in ACP topics were all high (median ≥ 4). Despite the perception that ACP is very important (M = 4.9) and the responsibility of PCCMCs (M = 3.7), the majority of respondents estimated that 40% or fewer patients have had ACP. Ratings of willingness to conduct ACP (M = 3.7) and comfort level (M = 3.4) were moderate but significantly exceeded ratings of ability (M = 2.9), comfort (M = 3.5), and confidence (M = 2.8). Conclusion: There was a striking disconnect between perceptions of the importance of completing ACP for persons with dementia and actual ACP completion rates. Primary Care Collaborative Memory Clinics may be in an ideal position to support ACP discussions; however, there is a need to improve health-care professionals’ knowledge and attitudes toward ACP.

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Development of a Scale to Assess Physician Advance Care Planning Self-Efficacy

Abstract: The final ACP-SE scale included 17 items and demonstrated high internal consistency.

Cited by 26 publications

References 20 publications

Investigation and Analysis of Undergraduate Nursing Students’ Attitudes Toward Advanced Care Planning and Their Willingness to Implement

Investigation and Analysis of Undergraduate Nursing Students’ Attitudes Toward Advanced Care Planning and Their Willingness to Implement

Implementing the theory-based advance care planning ACP+ programme for nursing homes: study protocol for a cluster randomised controlled trial and process evaluation

Advanced Care Planning for Persons With Dementia in Primary Care: Attitudes and Barriers Among Health-Care Professionals

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