Disentangling Consumer and Provider Predictors of Advance Care Planning

Abstract

Factorial surveys were used to examine community-based long-term care providers' judgments about consumers' need for advance care planning (ACP) and comfort levels in discussing ACP. Providers (448 registered nurses and social workers) judged vignettes based on hypothetical consumers. Hierarchical linear models indicated providers judged consumers who were older, had end-stage diagnoses, multiple emergency department visits, and uninvolved caregivers as most in need of ACP. These variables explained 10% of the variance in judgments. Providers' beliefs about ACP predicted judgments of need for ACP and comfort level in discussing ACP. Provider characteristics explained more variance in comfort levels (44%) than in judgments of need (20%). This study demonstrates the need for tailored educational programs to increase comfort levels and address ACP misconceptions.

Current advance care planning practice in the Australian community: an online survey of home care package case managers and service managers

“…This survey showed that the uptake of ACP in HCP settings is low, with case managers reporting they are under supported to undertake ACP discussions with clients and lack experience and training with ACP. These results are similar to published international research [ 15 , 17 , 19 , 22 ].…”

“…A recent North American survey showed that case managers do not routinely initiate ACP with clients, despite the majority reporting past experience with ACP, holding the belief that most clients needed ACP and having high comfort levels in discussing the issues [ 22 ]. Similarly in our study, although 70% of case managers reported having had 1–12 discussions in the past 12 months, only 20% of those discussions progressed to documentation of treatment preferences.…”

A broader understanding of care managers’ attitudes of advance care planning: A concurrent nested design

“…This study is an expansion of our previous work examining ACP performed in the home and initiated by care managers (CMs) with expertise as registered nurses or social workers. In the past, we have used, separately, quantitative data to determine CM and consumer factors that influence the decision to initiate ACP conversations (Baughman et al., ), and qualitative data to explore how CMs define ACP and their role in the process (Baughman et al., ) and the narrative stories they told about ACP (Baughman, Aultman, Ludwick, & O'Neil, ). We did not analyse how merging and comparing the qualitative and quantitative data might better inform the diversity of attitudes, beliefs and perspectives of CM participants as they engage in ACP discussions.…”

Perceived language proficiency and pain assessment by registered and student nurses in native English‐speaking and EAL children aged 4–7 years

“…Factorial surveys have been used to examine human judgement through responses to written descriptions of scenarios such as fictive descriptions or vignettes (Shlay, Tran, Weinraub, & Harmon, ). They are a valid and reliable method to gain a nurse's judgements (Baughman et al., , ; Ludwick et al., ; Rattray et al., ; for a useful review of the method, see Evans et al., ).…”

“…They are a valid and reliable method to gain a nurse's judgements (Baughman et al, 2012(Baughman et al, , 2013Ludwick et al, 2004;Rattray et al, 2011; for a useful review of the method, see Evans et al, 2015).…”