Oral Presentation Palliative Care Nurses Australia Conference 2022

Hospital Patient Satisfaction with Advance Care Planning Discussions (#69)

Melanie Friedman 1 , Liz Reymond 2 3 , Jayne Henderson 2
  1. School of Medicine and Dentistry, Griffith University, Southport, Qld, Australia
  2. Brisbane South Palliative Care Collaborative, Queensland Health, Eight Mile Plains, Qld, Australia
  3. School of Medicine, Griffith University, Gold Coast, Qld, Australia

Background:

Advance care planning (ACP) is a process of communicating a person’s wishes about future care, taking into account their values, beliefs and treatment preferences. There is some debate about the optimal setting in which to hold ACP discussions.

Aim:

  • To examine patient satisfaction with hospital-based ACP discussions

Methods:

  • Following ethics approval, participants who had completed an ACP document, the Statement of Choices (SOC), in a hospital setting were invited to participate in an anonymous survey regarding their satisfaction with their ACP discussion.
  • Patients were recruited from 4 metropolitan Queensland hospitals.
  • Survey responses were quantitively and thematically analysed.

Findings:

64 people were surveyed. 98 percent of participants reported their ACP discussions were a positive experience overall. Significantly, participants over 70 years old identified a preference for completing their ACP discussions with hospital staff rather than their GP (FE=0.024, df=1, p<0.01, OR=0.79, 95%CI=[0.204,3.046]). Similarly, participants aged over-60 years and those with self-reported poor health also preferred ACP discussions in hospital (FE=0.088, df=1, p<0.01, 95%CI=[0.777,1.877]). Results trending towards significance indicate that the SOC form was easy to use and understand and hearing about ACP was more of a relief for females compared to males.   

Discussion:

Past studies indicate patients may prefer having ACP conversations with their GP. In contrast, this study indicates that at least some patients prefer ACP discussions in the hospital setting. Identifying the optimal setting in which to conduct ACP discussions for individuals is important as it has the potential to increase ACP uptake and it is widely acknowledged that ACP supports optimal outcomes for treatment decision-making, quality of life, end-of-life management, and bereavement outcomes.

This study was limited by its small sample size and potential for volunteer bias in participants hence results may not be generalisable.

Conclusion:

This pilot study yields base-line findings for future research to assist in improving ACP uptake by patients and healthcare providers alike. Additional research should be conducted to further explore patient preferences for ACP location and clinician.

Funding acknowledgement:

Metro South Health