Paediatric advance care plans: a cross-sectional survey of healthy young adults

Evans, Holly E.; Sansom-Daly, Ursula M; Bryant, Richard J.

doi:10.1136/bmjspcare-2019-001963

Cited by 4 publications

(2 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Evidence suggests that AYAs generally do want to be involved in end-of-life conversations, and that they have preferences for how these conversations happen [ 13 ]. However, other research suggests that AYAs vary in their level of engagement with end-of-life conversations, with some studies of both healthy and chronically-ill AYAs finding that some young people do not wish to be involved in end-of-life decision-making at all [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Attachment as a mechanism influencing end-of-life communication: An analogue investigation

Evans,

Sansom-Daly,

Bryant

2024

PLoS ONE

View full text Add to dashboard Cite

Talking about dying when faced with end-of-life may be important for achieving optimal outcomes for young people and their families. Given the lack of research on young people’s communication around end-of-life and death, this analogue study examined the role of attachment theory in conversations about dying. Experiment 1 assessed attachment security of 80 healthy young adults and randomised them to receive either an induction that raised awareness of one’s attachment figures or a neutral induction, and then primed them with an imagined scenario where they were diagnosed with an incurable illness. Participants then completed a self-report measure of their willingness to discuss end-of-life topics with family, friends, or a psychologist. The experimental attachment induction did not increase willingness to talk about end-of-life concepts. Experiment 2 extended this design and asked participants to describe these conversations and assessed the content of their imagined end-of-life conversations. Experiment 2 replicated the finding that enhancing individuals’ awareness of key attachment figures did not increase participants’ willingness to engage in end-of-life conversations. However, heightened attachment awareness led participants to talk more about their relationship with the person they were hypothetically talking with. Across both experiments, avoidant attachment tendencies reduced the likelihood that participants receiving the attachment prime would want to engage in end-of-life conversation. Overall, it seems there are important differences between individuals on willingness to talk about death, and this may be influenced by one’s attachment style. These results raise implications for the importance of attachment in the therapeutic relationship for healthcare professionals working with young people with life-limiting illnesses, such as cancer. Further research may shed light on how an individually tailored approach, taking into account attachment security, achieves the best outcomes for individuals who require end-of-life conversations.

show abstract

Section: Introductionmentioning

confidence: 99%

Attachment as a mechanism influencing end-of-life communication: An analogue investigation

Evans,

Sansom-Daly,

Bryant

2024

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…AYAs generally want to be involved in end-of-life communication and have preferences for how this happens [ 20 , 21 ]. However, AYAs vary in their level of engagement with end-of-life conversations, with some AYAs (both healthy and those with life-threatening illnesses) not wishing to be involved in end-of-life decision making [ 22 ], or conversations [ 23 ]. Barriers for AYAs include concerns that these conversations may be perceived as representing a loss of hope, may precipitate treatment discontinuation [ 24 , 25 ], or may negatively impact relationships with their health professionals [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

Adapting the Voicing My CHOiCES Advance Care Planning Communication Guide for Australian Adolescents and Young Adults with Cancer: Appropriateness, Acceptability, and Considerations for Clinical Practice

Sansom-Daly

Zhang

Evans

et al. 2023

Cancers

View full text Add to dashboard Cite

Background: Adolescents and young adults (AYAs) with life-threatening illnesses need support to discuss and voice their end-of-life choices. Voicing My CHOiCES (VMC) is a research-informed American advanced care planning guide designed to help facilitate these difficult discussions. This multi-perspective study aimed to evaluate its appropriateness, acceptability, and clinical considerations for Australian AYAs with cancer. Procedure: Forty-three participants including AYAs who were either undergoing or recently completed cancer treatment, their parents, and multidisciplinary health professionals assessed the acceptability of each VMC section quantitatively (appropriateness—yes/no, helpfulness and whether content caused stress—1 = not at all, to 5 = very) and qualitatively (sources of stress). AYAs also assessed the benefit and burden of completing several sections of the document, to inform clinical considerations. We conducted a mixed-methods analysis to obtain descriptive statistics and to identify prominent themes. Results: In terms of acceptability, almost all participants (96%) rated VMC as appropriate overall. Perceived helpfulness to their situation (to themselves/their child/their patients), to others, and stressfulness were rated, on average, as 4.1, 4.0, and 2.7/5, respectively. Stress was attributed to individual and personal factors, as well as interpersonal worries. All sections were considered more beneficial than burdensome, except for the Spiritual Thoughts section (Section 6). Conclusions: While VMC is an acceptable advance care planning guide for AYAs with cancer, changes to the guide were suggested for the Australian context. Health professionals implementing VMC will need to address and mitigate anticipated sources of stress identified here. Future research evaluating the impact of a new culturally adapted Australian VMC guide is an important next step. Finally, the clinical implications of the present study are suggested.

show abstract

The effectiveness of a brief intervention to increase the likelihood of advance care planning among college students

et al. 2021

View full text Add to dashboard Cite

Paediatric advance care plans: a cross-sectional survey of healthy young adults

Cited by 4 publications

References 4 publications

Attachment as a mechanism influencing end-of-life communication: An analogue investigation

Attachment as a mechanism influencing end-of-life communication: An analogue investigation

Adapting the Voicing My CHOiCES Advance Care Planning Communication Guide for Australian Adolescents and Young Adults with Cancer: Appropriateness, Acceptability, and Considerations for Clinical Practice

The effectiveness of a brief intervention to increase the likelihood of advance care planning among college students

Contact Info

Product

Resources

About