Understanding Advance Care Planning in oncology: Barriers, perceptions, and pathways toward patient-centered...

Area of Science:

• Oncology
• Bioethics
• Health Communication

Background:

• Advance Care Planning (ACP) is crucial for patient-centered end-of-life care.
• Understanding patient perspectives on ACP is vital for effective implementation.
• Limited research exists on ACP in middle-income Latin American contexts.

Purpose of the Study:

• To explore cancer patients' comprehension of Advance Care Planning (ACP).
• To identify barriers to effective ACP implementation in clinical practice.

Main Methods:

• Qualitative descriptive study with 61 Brazilian women with breast cancer.
• Data collected via sociodemographic questionnaire and follow-up interviews post-informational brochure.
• Interviews analyzed using qualitative research reporting guidelines.

Main Results:

• Most participants struggled to define ACP; nearly 40% could not.
• Key barriers identified: cultural resistance to discussing death, family/physician reliance for decisions, and information gaps.
• A multilevel model revealed how cultural taboos, family dependence, and systemic inertia impede ACP.

Conclusions:

• Misconceptions and systemic barriers hinder ACP in routine oncology care.
• A conceptual framework explains the marginalization of ACP.
• Interventions should focus on patient education, professional communication, and institutional support.