Traditional academic assumptions about advance care planning (ACP) include the following :
(1) the purpose of ACP is preparing for incapacity ;
(2) ACP is based on the ethical principle of autonomy and the exercise of control ;
(3) the focus of ACP is completing written advance directive forms ;
and (4) ACP occurs within the context of the physician-patient relationship.
These assumptions about ACP have never been empirically validated.
To examine the traditional academic assumptions by exploring ACP from the perspective of patients actively participating in the planning process.
Forty-eight patients (30 men and 18 women with a mean age of 48.3 years) who were undergoing hemodialysis were interviewed 6 months after receiving an advance directive form.
Their experience of ACP was noted in interviews that were audiotaped, transcribed, and analyzed.
The participants said that their purpose in ACP was to prepare for death and dying, and their underlying goals included the exercise of control and an attempt to relieve burdens placed on loved ones.
Advance care planning was viewed as a social process, and completing a written advance directive form was often regarded as unnecessary.
Participants often involved close loved ones, but physicians infrequently.
The traditional academic assumptions are not fully supported from the perspective of patients involved in ACP. (...)
Mots-clés Pascal : Soin intensif, Planning avancement, Conceptualisation, Arbre décision, Homme, Perspective, Organisation santé
Mots-clés Pascal anglais : Intensive care, Construction scheduling, Conceptualization, Decision tree, Human, Perspective, Public health organization
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0238578
Code Inist : 002B30A01C. Création : 11/09/1998.