Differences in advance care planning among nursing home care staff
BackgroundA team-based approach has been advocated for advance care planning in nursing homes. While nurses are often put forward to take the lead, it is not clear to what extent other professions could be involved as well.ObjectivesTo examine to what extent engagement in advance care planning pract...
| Authors: | ; ; ; ; ; ; ; |
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| Tipo de documento: | Recurso Electrónico Artigo |
| Idioma: | Inglês |
| Verificar disponibilidade: | HBZ Gateway |
| Journals Online & Print: | Carregar...
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| Fernleihe: | Fernleihe für die Fachinformationsdienste |
| Publicado em: |
Sage
2021
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| Em: |
Nursing ethics
Ano: 2021, Volume: 28, Número: 7/8, Páginas: 1210-1227 |
| Outras palavras-chave: | B
Advance Care Planning
B Nursing Homes B Nurses B Self-efficacy B Autonomy B person-centred care B Knowledge |
| Acesso em linha: |
Presumably Free Access Volltext (lizenzpflichtig) |
| Resumo: | BackgroundA team-based approach has been advocated for advance care planning in nursing homes. While nurses are often put forward to take the lead, it is not clear to what extent other professions could be involved as well.ObjectivesTo examine to what extent engagement in advance care planning practices (e.g. conversations, advance directives), knowledge and self-efficacy differ between nurses, care assistants and allied care staff in nursing homes.DesignSurvey study.Participants/settingThe study involved a purposive sample of 14 nursing homes in Flanders, Belgium. Nurses, care assistants and allied care staff (e.g. social workers, physical therapists) completed a survey.Ethical considerationsThe study was approved by the University Hospital of Brussels (B.U.N. 143201834759), as part of a cluster randomized controlled trial (clinicaltrials.gov NCT03521206).ResultsOne hundred ninety-six nurses, 319 care assistants and 169 allied staff participated (67% response rate). After adjusting for confounders, nurses were significantly more likely than care assistants to have carried out advance care planning conversations (odds ratio 4; 95% confidence interval 1.73–9.82; p < 0.001) and documented advance care planning (odds ratio 2.67; 95% confidence interval 1.29–5.56; p < 0.001); differences not found between allied staff and care assistants. Advance care planning knowledge total scores differed significantly, with nurses (estimated mean difference 0.13 (score range 0–1); 95% confidence interval 0.08–0.17; p < 0.001) and allied staff (estimated mean difference 0.07; 95% confidence interval 0.03–0.12; p < 0.001) scoring higher than care assistants. We found no significant differences regarding self-efficacy.DiscussionWhile nursing home nurses conducted more advance care planning conversations and documentation than allied care staff and care assistants, these two professional groups may be a valuable support to nurses in conducting advance care planning, if provided with additional training.ConclusionsAllied care staff and care assistants, if trained appropriately, can be involved more strongly in advance care planning to enhance relational and individual autonomy of nursing home residents, alongside nurses. Future research to improve and implement advance care planning should consider this finding at the intervention development stage. |
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| ISSN: | 1477-0989 |
| Obras secundárias: | Enthalten in: Nursing ethics
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| Persistent identifiers: | DOI: 10.1177/0969733021994187 |