Health Care Professionals Perspectives on Advance Care Planning

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Health Care Professionals Perspectives on
Advance Care Planning

• Andrea Con, PhD
• CIHR Cross-Cultural Palliative NET
• Sociobehavioural Research Centre
• British Columbia Cancer Agency

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Acknowledgements

• Health Canada
• Canadian Institutes of Health Research
• Cross-Cultural Palliative New Emerging
• Team (NET)

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Objectives

• Identify and define cross-cultural issues in ACP
  from the perspective of HCP providing
  palliative/EOL care
• Determine understandings, beliefs, and
  interpretations of terminal illness, suffering,
  death, and dying
• Identify factors that may influence the
  responsiveness to ACP

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What is advance care planning?
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Defining ACP

• A process of reflection and communication in
  which a capable person makes decisions with
  respect to future health and/or personal care in
  the event that they become incapable of giving
  informed consent.
• The process may involve discussions with health
  care providers and significant others with whom
  the person has a relationship.
• ACP may result in the creation of an advance
  directive
• Dunbrack Health Canada
  Glossary Project 2006

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Key Informants

• 54 Key Informants
• Variety of HCP
• Specialized organizations (palliative, hospice
  and EOL care)

• Physician
• Nurse
• Social worker
• Chaplain
• Bioethicist
• Researchers
• Others

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Key Informants

• Cultural backgrounds
• 78 Caucasian
• 9 South Asian
• 13 Aboriginal, Chinese, Iranian

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Results General Themes

• Level of training
• Reflect on own thoughts/feelings regarding EOL
• No real consensus on who should conduct ACP
• Conversation vs. document

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General Themes

• Preferred to conduct ACP early in the disease
  process when patients are healthy
• Communication with patient/family/team members is
  a challenge
• If not familiar with culture, important to have
  interpreter of the same cultural background as
  their patient and/or to seek pastoral services

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Implications

• Public Education
• ACP specific to disease
• Engage communities to develop outreach programs
• Palliative care should be a medical specialty
• Research
• Organizations/health care facilities create
  pathways to guide HCP in ACP conversation

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For more information, please visithttp//www.bc
cancer.bc.ca/RES/ResearchPrograms/SBR/default.htm