The use of behavioural theories in end-of-life care research: A systematic review

Scherrens, Anne-Lore; Beernaert, Kim; Robijn, Lenzo; Deliëns, Luc; Pauwels, N.; Cohen, Joachim; Deforche, Benedicte

doi:10.1177/0269216318758212

Cited by 24 publications

(35 citation statements)

References 61 publications

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“…Whilst people with breast cancer require support, especially those with advanced cancer (47), so too do people with other diagnoses. Studies reviewed are mostly not underpinned by any form of theory, a trend also identified in a recent review of behavioural theories in end-of-life care research (48). Peer support intervention descriptions were often poor, it was challenging to extract details from many included papers, such as understanding the intervention at 'Cairn Centres' (25), the use of former patients (27), or the form and function of some groups (34).…”

Section: Comparison With Previous Reviewsmentioning

confidence: 99%

Peer support for people with advanced cancer: a systematically constructed scoping review of quantitative and qualitative evidence

Walshe

Roberts

2018

Current Opinion in Supportive &Amp; Palliative Care

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Section: Comparison With Previous Reviewsmentioning

confidence: 99%

Peer support for people with advanced cancer: a systematically constructed scoping review of quantitative and qualitative evidence

Walshe

Roberts

2018

Current Opinion in Supportive &Amp; Palliative Care

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“…11 Bandura's 12 theory has been used as a model to evaluate relationships between knowledge, self-efficacy and behaviour in research regarding health promotion, palliative care and recently in research regarding patients' readiness to engage in advance care planning. [13][14][15][16] We know that knowledge about advance care planning is associated with self-efficacy and vice versa. 8,17 However, our understanding whether and to what extent these constructs also relate to professionals' engagement in actual advance care planning practices is incomplete.…”

Section: Introductionmentioning

confidence: 99%

Nurses’ self-efficacy, rather than their knowledge, is associated with their engagement in advance care planning in nursing homes: A survey study

et al. 2020

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Background: Considering social cognitive theory and current literature about successful advance care planning in nursing homes, sufficient knowledge and self-efficacy are important preconditions for staff to be able to carry out advance care planning in practice. Aim: Exploring to what extent nurses’ knowledge about and self-efficacy is associated with their engagement in advance care planning in nursing homes. Design: Survey study as part of a baseline measurement of a randomised controlled cluster trial (NCT03521206). Setting/participants: Nurses in a purposive sample of 14 nursing homes in Belgium. Methods: A survey was distributed among nurses, evaluating knowledge (11 true/false items), self-efficacy (12 roles and tasks on 10-point Likert-type scale) and six advance care planning practices (yes/no), ranging from performing advance care planning conversations to completing advance directives. Results: A total of 196 nurses participated (66% response rate). While knowledge was not significantly associated with advance care planning practices, self-efficacy was. One unit’s increase in self-efficacy was statistically associated with an estimated 32% increase in the number of practices having carried out. Conclusions: Nurses’ engagement in advance care planning practices is mainly associated with their self-efficacy rather than their knowledge. Further research is necessary to improve the evidence regarding the causal relationship between constructs. However, these results suggest that educational programmes that focus solely on knowledge might not lead to increasing uptake of advance care planning in nurses.

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“…The practicebased design of ACP conversation guides complicates the understanding of the communicative process and illustrates the need for research to reveal underlying communicative, relational, and behavioral principles. 101,102 Our review shows there is a large body of existing interventions. The growing interest in ACP should therefore not result in the development of more new interventions, but in deeper evaluation of current strategies to understand which (components of) ACP interventions are effective and why.…”

Section: Resultsmentioning

confidence: 99%

Interventions Guiding Advance Care Planning Conversations: A Systematic Review

Fahner

Beunders

Heide

et al. 2019

Journal of the American Medical Directors Association

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Background: Advance care planning (ACP) is a communicative process of defining preferences for future medical care. Conversation guides support professionals to conduct ACP conversations, yet insight into essential components is limited. Objectives: To evaluate the content, rationale, and empirical evidence on the effect of ACP interventions based on conversation guides. Methods: MEDLINE, Embase, PsycINFO, and CINAHL were searched from January 1, 1998, to February 23, 2018, to identify peer-reviewed articles describing or evaluating ACP interventions based on scripted conversation guides. A thematic analysis of the guides was performed. Data on intervention characteristics, underlying rationale, and empirical evidence were extracted by 2 authors independently using a predesigned form. Assessment of risk of bias and quality of reporting was performed using Cochrane tools and COREQ, respectively. Results: Eighty-two articles reporting on 34 unique interventions met the inclusion criteria. Analysis of the conversation guides revealed a framework for ACP conversations consisting of 4 phases: preparation, initiation, exploration, and action. Exploration of patient's perspectives on illness, living well, end-of-life (EOL) issues, and decision making formed the core part of the guides. Their design was often expertbased, without an underlying theoretical background. Empirical evidence on the effect of the interventions was based on heterogeneous outcome measures. Dyad congruence and preference documentation rates increased among intervention subjects in most studies. The studies showed varying effects on knowledge of ACP, decisional conflict, quality of communication, and preferences-concordant care. Qualitative research showed that participants appreciate the importance and benefits of ACP conversations, yet perceive them as difficult and emotional. Conclusion: ACP conversation guides address a diversity of themes regarding illness, EOL issues, and decision making. There is a focus on the exploration of patient's perspectives and preferences. Evidence on the translation of explorative information into specific treatment preferences and consequences for care as provided is limited.

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The use of behavioural theories in end-of-life care research: A systematic review

Abstract: In end-of-life care research, the use of behavioural theories is limited. As many behaviours can determine the quality of care, their more extensive use may be warranted if we want to better understand and influence behaviours and improve end-of-life care.

Cited by 24 publications

References 61 publications

Peer support for people with advanced cancer: a systematically constructed scoping review of quantitative and qualitative evidence

Peer support for people with advanced cancer: a systematically constructed scoping review of quantitative and qualitative evidence

Nurses’ self-efficacy, rather than their knowledge, is associated with their engagement in advance care planning in nursing homes: A survey study

Interventions Guiding Advance Care Planning Conversations: A Systematic Review

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