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Content analysis of Advance Directives completed by patients with advanced cancer as part of an Advance Care Planning intervention: insights gained from the ACTION trial

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Content analysis of Advance Directives completed by patients with advanced cancer as part of an Advance Care Planning intervention: insights gained from the ACTION trial. / Zwakman, M; van Delden, Johannes J. M.; Caswell, Glenys et al.
In: Supportive Care in Cancer, Vol. 28, No. 3, 05.07.2019, p. 1513–1522.

Research output: Contribution to Journal/Magazine › Journal article › peer-review

Harvard

Zwakman, M, van Delden, JJM, Caswell, G, Deliens, L, Ingravallo, F, jabbarian, L, Johnsoen, A, Korfage, IJ, Mimić, A, Arnfeldt, C, Preston, N & Kars, M 2019, 'Content analysis of Advance Directives completed by patients with advanced cancer as part of an Advance Care Planning intervention: insights gained from the ACTION trial', Supportive Care in Cancer, vol. 28, no. 3, pp. 1513–1522. https://doi.org/10.1007/s00520-019-04956-1

APA

Zwakman, M., van Delden, J. J. M., Caswell, G., Deliens, L., Ingravallo, F., jabbarian, L., Johnsoen, A., Korfage, I. J., Mimić, A., Arnfeldt, C., Preston, N., & Kars, M. (2019). Content analysis of Advance Directives completed by patients with advanced cancer as part of an Advance Care Planning intervention: insights gained from the ACTION trial. Supportive Care in Cancer, 28(3), 1513–1522. Advance online publication. https://doi.org/10.1007/s00520-019-04956-1

Vancouver

Zwakman M, van Delden JJM, Caswell G, Deliens L, Ingravallo F, jabbarian L et al. Content analysis of Advance Directives completed by patients with advanced cancer as part of an Advance Care Planning intervention: insights gained from the ACTION trial. Supportive Care in Cancer. 2019 Jul 5;28(3):1513–1522. Epub 2019 Jul 5. doi: 10.1007/s00520-019-04956-1

Author

Zwakman, M ; van Delden, Johannes J. M. ; Caswell, Glenys et al. / Content analysis of Advance Directives completed by patients with advanced cancer as part of an Advance Care Planning intervention : insights gained from the ACTION trial. In: Supportive Care in Cancer. 2019 ; Vol. 28, No. 3. pp. 1513–1522.

Bibtex

@article{515078b5d2d04e44a66227c51e8b7ffd,
title = "Content analysis of Advance Directives completed by patients with advanced cancer as part of an Advance Care Planning intervention: insights gained from the ACTION trial",
abstract = "Purpose: Writing an Advance Directive (AD) is often seen as a part of Advance Care Planning (ACP). ADs may include specific preferences regarding future care and treatment and information that provides a context for healthcare professionals and relatives in case they have to make decisions for the patient. The aim of this study was to get insight into the content of ADs as completed by patients with advanced cancer who participated in ACP conversations. Methods: A mixed methods study involving content analysis and descriptive statistics was used to describe the content of completed My Preferences forms, an AD used in the intervention arm of the ACTION trial, testing the effectiveness of the ACTION Respecting Choices ACP intervention. Results: In total, 33% of 442 patients who received the ACTION RC ACP intervention completed a My Preferences form. Document completion varied per country: 10.4% (United Kingdom), 20.6% (Denmark), 29.2% (Belgium), 41.7% (the Netherlands), 61.3% (Italy) and 63.9% (Slovenia). Content analysis showed that {\textquoteleft}maintaining normal life{\textquoteright} and {\textquoteleft}experiencing meaningful relationships{\textquoteright} were important for patients to live well. Fears and worries mainly concerned disease progression, pain or becoming dependent. Patients hoped for prolongation of life and to be looked after by healthcare professionals. Most patients preferred to be resuscitated and 44% of the patients expressed maximizing comfort as their goal of future care. Most patients preferred {\textquoteleft}home{\textquoteright} as final place of care. Conclusions: My Preferences forms provide some insights into patients{\textquoteright} perspectives and preferences. However, understanding the reasoning behind preferences requires conversations with patients.",
keywords = "Advance Directive, Cancer, Content analysis, End of life",
author = "M Zwakman and {van Delden}, {Johannes J. M.} and Glenys Caswell and Luc Deliens and Francesca Ingravallo and Lea jabbarian and Anna Johnsoen and Korfage, {Ida J} and A Mimi{\'c} and Caroline Arnfeldt and Nancy Preston and M Kars",
year = "2019",
month = jul,
day = "5",
doi = "10.1007/s00520-019-04956-1",
language = "English",
volume = "28",
pages = "1513–1522",
journal = "Supportive Care in Cancer",
issn = "0941-4355",
publisher = "Springer Verlag",
number = "3",

}

RIS

TY - JOUR

T1 - Content analysis of Advance Directives completed by patients with advanced cancer as part of an Advance Care Planning intervention

T2 - insights gained from the ACTION trial

AU - Zwakman, M

AU - van Delden, Johannes J. M.

AU - Caswell, Glenys

AU - Deliens, Luc

AU - Ingravallo, Francesca

AU - jabbarian, Lea

AU - Johnsoen, Anna

AU - Korfage, Ida J

AU - Mimić, A

AU - Arnfeldt, Caroline

AU - Preston, Nancy

AU - Kars, M

PY - 2019/7/5

Y1 - 2019/7/5

N2 - Purpose: Writing an Advance Directive (AD) is often seen as a part of Advance Care Planning (ACP). ADs may include specific preferences regarding future care and treatment and information that provides a context for healthcare professionals and relatives in case they have to make decisions for the patient. The aim of this study was to get insight into the content of ADs as completed by patients with advanced cancer who participated in ACP conversations. Methods: A mixed methods study involving content analysis and descriptive statistics was used to describe the content of completed My Preferences forms, an AD used in the intervention arm of the ACTION trial, testing the effectiveness of the ACTION Respecting Choices ACP intervention. Results: In total, 33% of 442 patients who received the ACTION RC ACP intervention completed a My Preferences form. Document completion varied per country: 10.4% (United Kingdom), 20.6% (Denmark), 29.2% (Belgium), 41.7% (the Netherlands), 61.3% (Italy) and 63.9% (Slovenia). Content analysis showed that ‘maintaining normal life’ and ‘experiencing meaningful relationships’ were important for patients to live well. Fears and worries mainly concerned disease progression, pain or becoming dependent. Patients hoped for prolongation of life and to be looked after by healthcare professionals. Most patients preferred to be resuscitated and 44% of the patients expressed maximizing comfort as their goal of future care. Most patients preferred ‘home’ as final place of care. Conclusions: My Preferences forms provide some insights into patients’ perspectives and preferences. However, understanding the reasoning behind preferences requires conversations with patients.

AB - Purpose: Writing an Advance Directive (AD) is often seen as a part of Advance Care Planning (ACP). ADs may include specific preferences regarding future care and treatment and information that provides a context for healthcare professionals and relatives in case they have to make decisions for the patient. The aim of this study was to get insight into the content of ADs as completed by patients with advanced cancer who participated in ACP conversations. Methods: A mixed methods study involving content analysis and descriptive statistics was used to describe the content of completed My Preferences forms, an AD used in the intervention arm of the ACTION trial, testing the effectiveness of the ACTION Respecting Choices ACP intervention. Results: In total, 33% of 442 patients who received the ACTION RC ACP intervention completed a My Preferences form. Document completion varied per country: 10.4% (United Kingdom), 20.6% (Denmark), 29.2% (Belgium), 41.7% (the Netherlands), 61.3% (Italy) and 63.9% (Slovenia). Content analysis showed that ‘maintaining normal life’ and ‘experiencing meaningful relationships’ were important for patients to live well. Fears and worries mainly concerned disease progression, pain or becoming dependent. Patients hoped for prolongation of life and to be looked after by healthcare professionals. Most patients preferred to be resuscitated and 44% of the patients expressed maximizing comfort as their goal of future care. Most patients preferred ‘home’ as final place of care. Conclusions: My Preferences forms provide some insights into patients’ perspectives and preferences. However, understanding the reasoning behind preferences requires conversations with patients.

KW - Advance Directive

KW - Cancer

KW - Content analysis

KW - End of life

U2 - 10.1007/s00520-019-04956-1

DO - 10.1007/s00520-019-04956-1

M3 - Journal article

VL - 28

SP - 1513

EP - 1522

JO - Supportive Care in Cancer

JF - Supportive Care in Cancer

SN - 0941-4355

IS - 3

ER -