How Do General Practitioners Conceptualise Advance Care Planning in Their Practice? A Qualitative Study

Area of Science:

• General Practice
• Palliative Care
• Medical Ethics

Background:

• Advance care planning (ACP) is essential for aligning patient preferences with medical care, particularly in end-of-life scenarios.
• Understanding general practitioners' (GPs) perspectives is key to improving ACP integration into routine practice.

Purpose of the Study:

• To explore how general practitioners (GPs) conceptualize advance care planning (ACP) based on their practical experiences.
• To identify the diverse understandings and tasks associated with ACP from the GP's viewpoint.

Main Methods:

• Qualitative study involving five focus groups with 36 general practitioners (GPs).
• Discussions were analyzed using a constant comparative method to identify recurring themes.

Main Results:

• Four main themes emerged: organizing professional care, preparing for death and discussing palliative care, discussing care goals and treatment decisions, and completing advance directives.
• GPs conceptualized ACP in terms of its content and their tasks, including the active versus passive initiation of ACP.
• A significant theme was the GP's role in actively initiating ACP versus waiting for patient requests.

Conclusions:

• GPs exhibit varied conceptualizations of ACP, with some focusing on limited aspects.
• A shared understanding and agreement on the purpose and goals of ACP are necessary for successful implementation.
• Systematic integration of ACP into routine practice is needed to improve the uptake of all its elements.