Rights statement: The final, definitive version of this article has been published in the Journal, Palliative Medicine, 35 (7), 2021, © SAGE Publications Ltd, 2021 by SAGE Publications Ltd at the Palliative Medicine page: https://journals.sagepub.com/home/pmj on SAGE Journals Online: http://journals.sagepub.com/
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Final published version
Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
}
TY - JOUR
T1 - Understanding and addressing challenges for advance care planning in the COVID-19 pandemic
T2 - An analysis of the UK CovPall survey data from specialist palliative care services
AU - Bradshaw, A
AU - Dunleavy, Lesley
AU - Walshe, Catherine
AU - Preston, Nancy
AU - Cripps, Rachel
AU - Hocaoglu, Mevhibe
AU - Bajwah, Sabrina
AU - Maddocks, Matthew
AU - Oluyase, Adejoke
AU - Sleeman, K.E.
AU - Higginson, Irene J.
AU - Fraser, Lorna
AU - Murtagh, Fliss
N1 - The final, definitive version of this article has been published in the Journal, Palliative Medicine, 35 (7), 2021, © SAGE Publications Ltd, 2021 by SAGE Publications Ltd at the Palliative Medicine page: https://journals.sagepub.com/home/pmj on SAGE Journals Online: http://journals.sagepub.com/
PY - 2021/7/1
Y1 - 2021/7/1
N2 - Background: Specialist palliative care services play an important role in conducting advance care planning during COVID-19. Little is known about the challenges to advance care planning in this context, or the changes services made to adapt. Aim: Describe the challenges that UK specialist palliative care services experienced regarding advance care planning during COVID-19 and changes made to support timely conversations. Design: Online survey of UK palliative/hospice services’ response to COVID-19. Closed-ended responses are reported descriptively. Open-ended responses were analysed using a thematic Framework approach using the Social Ecological Model to understand challenges. Respondents: Two hundred and seventy-seven services. Results: More direct advance care planning was provided by 38% of services, and 59% provided more support to others. Some challenges to advance care planning pre-dated the pandemic, whilst others were specific to/exacerbated by COVID-19. Challenges are demonstrated through six themes: complex decision making in the face of a new infectious disease; maintaining a personalised approach; COVID-19-specific communication difficulties; workload and pressure; sharing information; and national context of fear and uncertainty. Two themes demonstrate changes made to support: adapting local processes and adapting local structures. Conclusions: Professionals and healthcare providers need to ensure advance care planning is individualised by tailoring it to the values, priorities, and ethnic/cultural/religious context of each person. Policymakers need to consider how high-quality advance care planning can be resourced as a part of standard healthcare ahead of future pandemic waves. In facilitating this, we provide questions to consider at each level of the Social Ecological Model.
AB - Background: Specialist palliative care services play an important role in conducting advance care planning during COVID-19. Little is known about the challenges to advance care planning in this context, or the changes services made to adapt. Aim: Describe the challenges that UK specialist palliative care services experienced regarding advance care planning during COVID-19 and changes made to support timely conversations. Design: Online survey of UK palliative/hospice services’ response to COVID-19. Closed-ended responses are reported descriptively. Open-ended responses were analysed using a thematic Framework approach using the Social Ecological Model to understand challenges. Respondents: Two hundred and seventy-seven services. Results: More direct advance care planning was provided by 38% of services, and 59% provided more support to others. Some challenges to advance care planning pre-dated the pandemic, whilst others were specific to/exacerbated by COVID-19. Challenges are demonstrated through six themes: complex decision making in the face of a new infectious disease; maintaining a personalised approach; COVID-19-specific communication difficulties; workload and pressure; sharing information; and national context of fear and uncertainty. Two themes demonstrate changes made to support: adapting local processes and adapting local structures. Conclusions: Professionals and healthcare providers need to ensure advance care planning is individualised by tailoring it to the values, priorities, and ethnic/cultural/religious context of each person. Policymakers need to consider how high-quality advance care planning can be resourced as a part of standard healthcare ahead of future pandemic waves. In facilitating this, we provide questions to consider at each level of the Social Ecological Model.
KW - Palliative care
KW - hospices
KW - coronavirus
KW - surveys and questionnaires
KW - pandemics
KW - advance care planning
U2 - 10.1177/02692163211017387
DO - 10.1177/02692163211017387
M3 - Journal article
VL - 35
SP - 1225
EP - 1237
JO - Palliative Medicine
JF - Palliative Medicine
SN - 0269-2163
IS - 7
ER -