Nurses' perceptions of advance care planning communication with patients and families in long-term care settings

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Vieira, Ivone
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Advance care planning (ACP) communication falls under nurses’ scope of practice, yet we have limited understanding of the experiences of nurses working in long-term care (LTC) settings with these future-oriented or end-of-life discussions. The purpose of this study was to explore nurses' perceptions of ACP communication with residents/patients and families in LTC settings. The qualitative method of interpretive description was used to answer three research questions: “What are LTC nurses' ACP experiences”; “What are nurses’ perceptions of their ACP roles”; and, “What barriers and facilitators to ACP communication exist in their practice?” A convenience sample of fifteen registered nurses and licensed practical nurses working in LTC settings in Manitoba, Canada volunteered for the study. Individual one-on-one telephone interviews were conducted using a semi-structured interview guide. Using Braun and Clarke’s thematic analysis process two themes were identified: A Sense of an Ethical Obligation to Engage in ACP Communication; and Sensibility of the Determinants of ACP Communication. Nurses described how their ethical obligation to engage in ACP communication was influenced by their definitions of ACP, the approaches to ACP in their workplaces, and their personal and professional ACP experiences. Nurses identified roles and actions that flow from this ethical obligation and factors, both personal and structural, that hinder and catalyze ACP communication in LTC. This study adds to the scholarly literature related to LTC nurses’ ACP communication. The study findings point to the need for improvements in ACP policies, procedures, practice, and education, and research for nurses in a variety of settings. Keywords: advance care planning, nurses, long-term care, interpretive description
Advance care planning, Nurses, Long-term care, Interpretive description