Cargando…

Advance care planning in stroke: influence of time on engagement in the process

PURPOSE: Individuals who experience stroke have a higher likelihood of subsequent stroke events, making it imperative to plan for future medical care. In the event of a further serious health event, engaging in the process of advanced care planning (ACP) can help family members and health care profe...

Descripción completa

Detalles Bibliográficos
Autores principales: Green, Theresa, Gandhi, Shreyas, Kleissen, Tessa, Simon, Jessica, Raffin-Bouchal, Shelley, Ryckborst, Karla
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3908836/
https://www.ncbi.nlm.nih.gov/pubmed/24493922
http://dx.doi.org/10.2147/PPA.S54822
_version_ 1782301752636211200
author Green, Theresa
Gandhi, Shreyas
Kleissen, Tessa
Simon, Jessica
Raffin-Bouchal, Shelley
Ryckborst, Karla
author_facet Green, Theresa
Gandhi, Shreyas
Kleissen, Tessa
Simon, Jessica
Raffin-Bouchal, Shelley
Ryckborst, Karla
author_sort Green, Theresa
collection PubMed
description PURPOSE: Individuals who experience stroke have a higher likelihood of subsequent stroke events, making it imperative to plan for future medical care. In the event of a further serious health event, engaging in the process of advanced care planning (ACP) can help family members and health care professionals (HCPs) make medical decisions for individuals who have lost the capacity to do so. Few studies have explored the views and experiences of patients with stroke about discussing their wishes and preferences for future medical events, and the extent to which stroke HCPs engage in conversations around planning for such events. In this study, we sought to understand how the process of ACP unfolded between HCPs and patients post-stroke. PATIENTS AND METHODS: Using grounded theory (GT) methodology, we engaged in direct observation of HCP and patient interactions on an acute stroke unit and two stroke rehabilitation units. Using semi-structured interviews, 14 patients and four HCPs were interviewed directly about the ACP process. RESULTS: We found that open and continual ACP conversations were not taking place, patients experienced an apparent lack of urgency to engage in ACP, and HCPs were uncomfortable initiating ACP conversations due to the sensitive nature of the topic. CONCLUSION: In this study, we identified lack of engagement in ACP post-stroke, attributable to patient and HCP factors. This encourages us to look further into the process of ACP in order to develop open communication between the patient with stroke, their families, and stroke HCPs.
format Online
Article
Text
id pubmed-3908836
institution National Center for Biotechnology Information
language English
publishDate 2014
publisher Dove Medical Press
record_format MEDLINE/PubMed
spelling pubmed-39088362014-02-03 Advance care planning in stroke: influence of time on engagement in the process Green, Theresa Gandhi, Shreyas Kleissen, Tessa Simon, Jessica Raffin-Bouchal, Shelley Ryckborst, Karla Patient Prefer Adherence Original Research PURPOSE: Individuals who experience stroke have a higher likelihood of subsequent stroke events, making it imperative to plan for future medical care. In the event of a further serious health event, engaging in the process of advanced care planning (ACP) can help family members and health care professionals (HCPs) make medical decisions for individuals who have lost the capacity to do so. Few studies have explored the views and experiences of patients with stroke about discussing their wishes and preferences for future medical events, and the extent to which stroke HCPs engage in conversations around planning for such events. In this study, we sought to understand how the process of ACP unfolded between HCPs and patients post-stroke. PATIENTS AND METHODS: Using grounded theory (GT) methodology, we engaged in direct observation of HCP and patient interactions on an acute stroke unit and two stroke rehabilitation units. Using semi-structured interviews, 14 patients and four HCPs were interviewed directly about the ACP process. RESULTS: We found that open and continual ACP conversations were not taking place, patients experienced an apparent lack of urgency to engage in ACP, and HCPs were uncomfortable initiating ACP conversations due to the sensitive nature of the topic. CONCLUSION: In this study, we identified lack of engagement in ACP post-stroke, attributable to patient and HCP factors. This encourages us to look further into the process of ACP in order to develop open communication between the patient with stroke, their families, and stroke HCPs. Dove Medical Press 2014-01-24 /pmc/articles/PMC3908836/ /pubmed/24493922 http://dx.doi.org/10.2147/PPA.S54822 Text en © 2014 Green et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Green, Theresa
Gandhi, Shreyas
Kleissen, Tessa
Simon, Jessica
Raffin-Bouchal, Shelley
Ryckborst, Karla
Advance care planning in stroke: influence of time on engagement in the process
title Advance care planning in stroke: influence of time on engagement in the process
title_full Advance care planning in stroke: influence of time on engagement in the process
title_fullStr Advance care planning in stroke: influence of time on engagement in the process
title_full_unstemmed Advance care planning in stroke: influence of time on engagement in the process
title_short Advance care planning in stroke: influence of time on engagement in the process
title_sort advance care planning in stroke: influence of time on engagement in the process
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3908836/
https://www.ncbi.nlm.nih.gov/pubmed/24493922
http://dx.doi.org/10.2147/PPA.S54822
work_keys_str_mv AT greentheresa advancecareplanninginstrokeinfluenceoftimeonengagementintheprocess
AT gandhishreyas advancecareplanninginstrokeinfluenceoftimeonengagementintheprocess
AT kleissentessa advancecareplanninginstrokeinfluenceoftimeonengagementintheprocess
AT simonjessica advancecareplanninginstrokeinfluenceoftimeonengagementintheprocess
AT raffinbouchalshelley advancecareplanninginstrokeinfluenceoftimeonengagementintheprocess
AT ryckborstkarla advancecareplanninginstrokeinfluenceoftimeonengagementintheprocess