Advance care planning among stroke patients: A scoping review

This study aimed to describe the implementation of advance care planning (ACP) in patients with stroke.

A scoping review was conducted according to the Arksey and O'Malley framework. Accordingly, we searched for articles published in ScienceDirect, PubMed, Scopus, ProQuest, and Medline. The inclusion criteria were original research on ACP among adult or elderly stroke patients, hospital- or community-based studies, and those published in English or Indonesian. Qualitative analysis was then used to identify keywords, categories, and themes.

Among the 1,050 articles identified, only 8 satisfied the inclusion criteria, indicating that limited studies were available for ACP interventions among stroke patients. Four themes were ultimately identified: the strategy implementation of ACP, the challenges of ACP implementation, the benefits of ACP, and the factors influencing ACP. Strategy ACP implementation included the ACP method, the communication style, participation role, media used, and ACP documentation. Lack of information about ACP, facilities, incapacitated patients, and reluctance to implement have become challenges to implementation in stroke. The benefits of ACP, particularly the outcomes of the ACP program, included awareness of ACP engagement, patients can express their wishes, and increased advance directive (AD) documentation. The factors influencing ACP included patient condition, knowledge, and appropriate ACP methods.

ACP has not been widely used when providing interventions for stroke patients. The implementation of ACP in stroke patients is full of challenges due to various patient conditions. Effective strategies are needed to improve ACP in stroke patients. It is necessary to develop an ACP for stroke patients' method that involves interprofessional collaboration, and studies on ACP in stroke patients need to be further conducted through interprofessional collaboration.