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Advance care planning in perinatal settings: national survey of implementation using Normalisation Process Theory
Karen L Shaw1, J Spry2, Carole Cummins2
1Institute of Applied Health Research, University of Birmingham, Birmingham, UK k.l.shaw@bham.ac.uk.
Archives of Disease in Childhood. Fetal and Neonatal Edition
|September 14, 2023
Summary
Perinatal advance care planning (PnACP) shows variation in UK and Ireland practice. Improved integration and staff training are needed to support families facing difficult decisions for babies with life-limiting conditions.
Area of Science:
- Perinatal medicine
- Healthcare policy
- Clinical practice
Background:
- Perinatal advance care planning (PnACP) aids families with life-limiting fetal conditions.
- Policy recommends PnACP, but evidence for perinatal implementation is limited.
Purpose of the Study:
- To survey UK and Ireland perinatal providers on current PnACP operationalization.
- To identify 'what' is implemented, processes, impact, and support needs.
Main Methods:
- Online questionnaire distributed to 108 health professionals across 90 UK and Ireland organizations.
- Data analyzed using descriptive statistics, thematic analysis, and Normalisation Process Theory.
Main Results:
- Significant variation in PnACP conceptualization and implementation observed.
- Existing PnACP tools are not routinely embedded; numerous barriers impact care quality.
- Professionals called for better palliative care integration and enhanced staff training.
Conclusions:
- Priorities include sharing best practices for PnACP.
- Effective strategies are needed for time-sensitive, uncertain decision-making in perinatal care.
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