The Influence of Family Communication Patterns in Advance Care Planning: A Young Adult's Perspective

Background: Advance care planning (ACP) is underutilized. To facilitate ACP and prepare adult children to be surrogates, we must understand how families communicate. This understanding can help prepare surrogates and reduce negative outcomes associated with medical decision-making for a loved one. Objectives: This study investigated the nature of family communication around ACP, the extent of young adults' engagement in ACP discussions with their parents, and the influence of family communication patterns on these conversations. Methods: A mixed-methods approach was utilized in the study. Thirty-nine young adults from a suburban college in Pennsylvania participated. Participants completed the revised family communication patterns instrument and participated in focus group interviews. Results: Analysis of the data revealed an average score of 3.56 (± 0.64) for conversation orientation and 2.93 (± 0.64) for conformity orientation. Structural coding identified distinct family communication patterns with some inconsistencies between measured and self-reported family types. Conclusions: The findings indicate that young adults can engage in ACP discussions with their parents, and family communication patterns may play a significant role in influencing these discussions. Future research should aim to leverage family communication patterns to foster more effective ACP conversations between young adults and their parents. Implications for Practice: Early and frequent advance care planning is essential to patient-centered care. Understanding family communication patterns can allow nurses to tailor conversations to patients and their families. This will assist individuals in making decisions congruent with their family members' wishes, reducing adverse outcomes related to medical decision-making.