Evaluation of outpatient advance care planning conversations among patients, nurses and physicians

Abstract

Introduction: Advance Care Planning (ACP) enables patients to define and discuss their goals and preferences for future treatment and care with family and healthcare professionals. The implementation of the Multidisciplinary Timely Undertaken Advance Care Planning (MUTUAL) intervention has recently been positively evaluated by healthcare professionals. In the MUTUAL intervention three different participants participate in one ACP conversation, namely patient, nurse and physician. We aimed to investigate how patient, nurse and physician who participated in an ACP conversation evaluate the ACP conversation within the MUTUAL intervention at seven outpatient clinics. Methods: A quantitative analysis was conducted using three different surveys for each study population group. Comments within the survey were analyzed with a qualitative approach. Results: Patients, nurses and physicians positively evaluated the conducted ACP conversation. Patients gave significantly higher scores than nurses and physicians. Patients stated that they experienced positive and confrontation feelings during the ACP process. The ACP process enables patients to discuss their wishes with their family and give family and healthcare professionals more insight into their treatment wishes. Lastly, the ACP process encouraged patients to think about their values and preferences. Conclusion: Our results showed that patients and healthcare professionals positively evaluate the ACP conversations within the MUTUAL intervention. Patients evaluated the ACP conversation with significantly higher scores than nurses and physicians when answering if the ACP conversation is worthwhile and how satisfied they were with the ACP conversation.