Construction of an advance care planning communication plan for intensive care unit patients based on the patient- and family-centered care model: a mixed-method study protocol

Abstract

Background The intensive care unit (ICU) has the highest patient mortality rate. Implementing advance care planning (ACP) in the ICU can improve patients’ sense of dignity in medical decision-making and alleviate psychological pressure on family members, although ACP remains a challenging concept. The ACP communication plan, grounded in the patient- and family-centered care (PFCC) model, promotes patient and family involvement in treatment decisions, safeguarding patient autonomy and preventing issues such as discrepancies between treatment intensity and expected prognosis. Methods The exploratory hybrid research protocol will be comprised of four implementation phases. Phase 1 will involve familiarizing the research team with the content and implementation strategies of ACP based on the PFCC model. In Phase 2, interviews regarding ACP will be conducted with ICU patients and their families to acquire a comprehensive understanding of their needs. Phase 3 will involve developing the ACP communication plan document utilizing the PFCC model. Phase 4 will focus on validating the feasibility of the plan through a two-group (control and intervention), single-center, parallel-group randomized controlled trial. Regarding data analysis, the primary and secondary outcome measures will be assessed at baseline, seven days after baseline, and 30 days after baseline. Discussion The implementation of ACP in the ICU is an important part of palliative care, as it ensures patients’ autonomy and allows them to receive treatment consistent with their wishes, which improves quality of life and reduces the financial and psychological burden on families. However, there have been few studies in this area. This study will integrate the PFCC model into a comprehensive ACP communication plan for ICU patients to empower them and their families in the decision-making process. Our sincere aspiration is that this project will enable medical decisions that align with patients’ preferences, ultimately enhancing the mental well-being of patients and their families, as well as alleviating the financial burden they face. Trial registration: Chinese Clinical Trial Register (ChiCTR2400086414).