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A Dyadic Perspective on Engagement in Advance Care Planning
Terri Fried1,2, Maria Zenoni1, Lynne Iannone3
1Clinical Epidemiology Research Center, VA Connecticut Healthcare System, West Haven, Connecticut.
Journal of the American Geriatrics Society
|December 3, 2016
Summary
Understanding patient and surrogate views on advance care planning (ACP) is crucial. Surrogates can influence ACP engagement, highlighting the need to address both parties
Area of Science:
- Gerontology and Palliative Care
- Health Communication
- Sociology of Health
Background:
- Advance care planning (ACP) involves discussions about future medical wishes.
- Understanding patient and surrogate perspectives is vital for effective ACP.
- Veterans aged 55+ and their surrogates were the focus group.
Purpose of the Study:
- To explore patient and surrogate viewpoints on participating in advance care planning.
- To identify facilitators and barriers to engagement in ACP activities.
Main Methods:
- Qualitative cross-sectional study design.
- Interviews with 31 veterans (55+) and their designated surrogates.
- Exploration of four key ACP activities and perceived engagement.
Main Results:
- Shared barriers and facilitators were identified by both patients and surrogates.
- Disagreements in perceived communication stemmed from information needs and readiness.
- Study participation itself improved shared understanding of ACP engagement for some dyads.
Conclusions:
- Surrogates play a dual role in facilitating or impeding ACP.
- Differing perceptions between patients and surrogates regarding ACP engagement are common.
- Effective ACP promotion requires addressing both parties' attitudes and fostering clear communication.
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