Experiences of COPD patients with a transmural Advance Care Planning trajectory

Abstract

Background: Chronic Obstructive Pulmonary Disease is the third leading cause of death worldwide. Professional care is in most of these cases aimed at improving quality of life and to prevent and relieve suffering, one approach is palliative care. A professional manner of supporting future care is Advance Care Planning. A top clinical hospital in the Netherlands developed a transmural Advance Care Planning trajectory which consists of three components: 1) an information leaflet, 2) a group meeting, and 3) a personal conversation. Aim: The aim of this study is to explore the experiences of Chronic Obstructive Pulmonary Disease patients with the transmural Advance Care Planning trajectory. Method: A generic qualitative study with nine semi-structured face-to-face and telephone interviews was conducted with Chronic Obstructive Pulmonary Disease patients. The interviews were conducted between February and April 2020. The interviews were assessed using a thematic analysis. Results: The results of the data analysis show recurring main themes across all three components. The main themes have a different content per component of the trajectory. The main themes for the information leaflet are ambivalence and readiness. Main themes from the group meeting are ambivalence, readiness, atmosphere and familiarity with the information. The main themes of the personal conversation are ambivalence, readiness, and atmosphere. Conclusion: This study offers healthcare professionals a series of patient experiences regarding opportunities for discussing future care in a way similar to Advance Care Planning. Important feelings of the patients were ambivalence, readiness and atmosphere. Patients are positive about continuing the Advance Care Planning trajectory. The findings and recommendations of this study can be helpful for evaluating the pilot trajectory.