[Primary care nurses' difficulties in advance care planning processes: A qualitative study]

Area of Science:

• Nursing
• Palliative Care
• Healthcare Management

Background:

• Advance care planning (ACP) is crucial for respecting patient autonomy in end-of-life care.
• Primary care nurses play a vital role in facilitating ACP discussions.
• Barriers exist that hinder nurses' ability to effectively promote ACP.

Purpose of the Study:

• To identify the specific difficulties encountered by primary care nurses in promoting advance care planning.
• To understand the factors influencing nurses' engagement in end-of-life care discussions.

Main Methods:

• Phenomenological qualitative methodology.
• Purposive sampling of 14 primary care nurses.
• In-depth interviews and content analysis using NVivo 8 software.

Main Results:

• Nurses reported difficulties including lack of knowledge, poor communication skills, limited experience, and negative emotions.
• Institutional barriers included time constraints and interprofessional interference.
• Patient, family, and societal attitudes towards death also presented obstacles.

Conclusions:

• Enhanced professional training in ACP, communication, and emotional support is essential.
• Health managers must allocate resources, time, and attention for early ACP interventions.
• A cultural shift is needed to encourage open end-of-life discussions and overcome avoidance.