An integrative review of stakeholder views on Advance Care Directives (ACD): Barriers and facilitators to initiation, documentation, storage, and implementation

Patient Education and Counseling
Bronwyn HemsleyShaun McCarthy

Abstract

To examine the views and experiences of patients and their health care providers on developing advance care planning (ACP) and advance care directives (ACD); and determine barriers and facilitators to ACD development, storage, and use, including implications for people with communication disability. An integrative review of 93 studies, analysed according to their content themes. Content themes encapsulated the initiation, documentation, and implementation stages of ACP/ACD. Lack of guidance for initiating and supporting ACP/ACD impedes discussions, and both patients and healthcare providers avoid discussions owing to fear of dying and reluctance to think about end-of-life. There are several barriers and facilitators to the initiation of ACP discussions, documentation and implementation of ACD, and little research exploring the views of legal professionals on the development, storage, or use of ACP documents. Further research is needed to explore the timing and responsibility of both legal and health professionals in initiating and supporting ACP discussions. It is important for healthcare providers to raise ACP discussions regularly so that patients have time to make informed advance care decisions. Storage of the document in a...Continue Reading

Citations

May 21, 2020·Journal of Nursing Care Quality·Kelli E CanadaMarilyn Rantz
Jun 3, 2020·Journal of Social Work in End-of-life & Palliative Care·Jennifer Dickman PortzElizabeth A Bayliss
Dec 10, 2020·The American Journal of Hospice & Palliative Care·Kristin R BaughmanDenise Kropp
May 2, 2021·Health Expectations : an International Journal of Public Participation in Health Care and Health Policy·Kimberly BuckKaren M Detering
Nov 13, 2020·ANS. Advances in Nursing Science·Zahra Rahemi, Tracy Fasolino
May 25, 2021·Health & Social Care in the Community·Ángela Fernández-RodríguezJesús Molina-Mula

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