What do hospitalists experience as barriers and helpful factors for having ACP conversations? A systematic qualitative evidence synthesis

Perspectives in Public Health
Birgit VanderhaeghenPeter Rober

Abstract

Hospitalists seem to struggle with advance care planning implementation. One strategy to help them is to understand which barriers and helpful factors they may encounter. This review aims to give an overview on what hospitalists experience as barriers and helpful factors for having advance care planning conversations. A systematic synthesis of the qualitative literature was conducted. A bibliographic search of English peer-reviewed publications in PubMed, Embase, CINAHL, Central, PsycINFO, and Web of Science was undertaken. Hospitalists report lacking communication skills which lead to difficulties with exploring values and wishes of patients, dealing with emotions of patients and families and approaching the conversation about letting a patient die. Other barriers are related to different interpretations of the concept advance care planning, cultural factors, like being lost in translation, and medicolegal factors, like fearing prosecution. Furthermore, hospitalists report that decision-making is often based on irrational convictions, and it is highly personal. Physician and patient characteristics, like moral convictions, experience, and personality play a role in the decision-making process. Hospitalists report that experien...Continue Reading

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Jan 5, 2020·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Mariken E StegmannSaskia F A Duijts
Sep 15, 2020·Palliative Care and Social Practice·Julian AbelHelen Kingston
May 20, 2021·Journal of Clinical Nursing·Marie CerulusBirgit Vanderhaeghen
Aug 3, 2021·BMC Health Services Research·Trygve Johannes L SævareidMorten Magelssen

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