Implementation of an Advance Care Planning Intervention in Nursing Homes: An International Multiple Case Study-Reference-Cited by-同舟云学术

Implementation of an Advance Care Planning Intervention in Nursing Homes: An International Multiple Case Study

Published:2024-02-13 Issue:6 Volume:64 Page:
ISSN:0016-9013
Container-title:The Gerontologist
language:en
Short-container-title:

Author:

Brazil Kevin¹^ORCID,Walshe Catherine²^ORCID,Doherty Julie¹^ORCID,Harding Andrew J E²^ORCID,Preston Nancy²^ORCID,Bavelaar Laura³^ORCID,Cornally Nicola⁴^ORCID,Di Giulio Paola⁵^ORCID,Gonella Silvia⁵^ORCID,Hartigan Irene⁴^ORCID,Henderson Catherine⁶^ORCID,Kaasalainen Sharon⁷^ORCID,Loucka Martin⁸^ORCID,Sussman Tamara⁹^ORCID,Vlckova Karolina⁸^ORCID,van der Steen Jenny T¹⁰^ORCID, ,Achterberg Wilco¹¹,Visser Mandy¹¹,Fitzgerald Serena¹²,Just Danielle¹³,Wilson Christine Brown¹⁴,Carter Gillian¹⁴,Simionato Laura¹⁵,Buckley Catherine¹⁶,Foley Tony¹⁷,Fox Siobhan¹⁸,Timmons Suzanne¹⁸,O’Caoimh Ronan¹⁸,O’Connell Selena¹⁹²⁰,Sweeney Catherine²¹,Cousins Emily²²,De Vries Kay²²,Dixon Josie²³,Dening Karen Harrison²⁴

Affiliation:

1. School of Nursing and Midwifery, Queen’s University Belfast , Belfast , UK

2. International Observatory on End of Life Care, Lancaster University , Lancaster , UK

3. Medical Research Ethics Committees United, St. Andonius Hospital , Nieuwegein , The Netherlands

4. School of Nursing and Midwifery, University College Cork , Cork , Republic of Ireland

5. Department of Public Health and Pediatrics, University of Torino , Turin , Italy

6. Care Policy and Evaluation Centre, The London School of Economics and Political Science , London , UK

7. School of Nursing, McMaster University , Hamilton , Ontario , Canada

8. Third Faculty of Medicine, Charles University , Prague , Czech Republic

9. School of Social Work, McGill University , Montreal , Quebec , Canada

10. Department of Primary and Community Care, Radboud University Medical Center, Radboudumc Alzheimer Center , Nijmegen , The Netherlands

11. Department of Public Health and Primary Care, Leiden University Medical Center , Leiden , The Netherlands

12. School of Nursing and Midwifery, University College Cork , Cork , Ireland

13. School of Nursing, McMaster University , Ontario , Canada

14. School of Nursing and Midwifery, Queen’s University Belfast , Belfast, Northern Ireland , UK

15. Department of Clinical and Biological Sciences, University of Torino , Torino , Italy

16. Northridge House Education and Research Centre , St. Lukes Home, Cork , Ireland

17. Department of General Practice, University College Cork , Cork , Ireland

18. Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork , Cork , Ireland

19. National Suicide Research Foundation, University College Cork , Cork , Ireland

20. School of Public Health, College of Medicine and Health, University College Cork , Cork , Ireland

21. Department of Medicine, University College Cork , Cork , Ireland

22. School of Nursing and Midwifery, De Montfort University , Leicester , UK

23. Care Policy and Evaluation Centre, London School of Economics and Political Science , London , UK

24. Dementia UK , London , UK

Abstract

Abstract Background and Objectives The inability of individuals in the advanced stage of dementia to communicate about preferences in care at the end-of-life poses a challenge for healthcare professionals and family carers. The proven effective Family Carer Decision Support intervention has been designed to inform family carers about end-of-life care options available to a person living with advanced dementia. The objectives of the mySupport study were to adapt the application of the intervention for use in different countries, assess impact on family satisfaction and decision-making, and identify costs and supportive conditions for the implementation of the intervention. Research Design and Methods A multiple-case study design was chosen where the nursing home was the case. Nursing homes were enrolled from six countries: Canada, Czech Republic, Italy, Netherlands, Republic of Ireland, and United Kingdom. Results Seventeen cases (nursing homes) participated, with a total of 296 interviews completed including family carers, nursing home staff, and health providers. Five themes relevant to the implementation of the intervention were identified: supportive relationships; committed staff; perceived value of the intervention; the influence of external factors on the nursing home; and resource impact of delivery. Discussion and Implications There is a commonality of facilitators and barriers across countries when introducing practice innovation. A key learning point was the importance of implementation being accompanied by committed and supported nursing home leadership. The nursing home context is dynamic and multiple factors influence implementation at different points of time.

Funder

EU Joint Programme-Neurodegenerative Disease Research

Canadian Institutes of Health Research

Ministry of Education, Youth and Sport

ZonMw the Netherlands Organisation for Health Research and Development

Health Research Board

Alzheimer’s Society

Publisher

Oxford University Press (OUP)

Link

https://academic.oup.com/gerontologist/advance-article-pdf/doi/10.1093/geront/gnae007/56668910/gnae007.pdf

Reference25 articles.

1. Developing country-specific questions about end-of-life care for nursing home residents with advanced dementia using the nominal group technique with family caregivers;Bavelaar,2022

2. The impact of the mySupport advance care planning intervention on family caregivers’ perceptions of decision-making and care for nursing home residents with dementia: Pretest-posttest study in six countries;Bavelaar,2023

3. Disseminating innovations in health care;Berwick,2003

4. Effectiveness of advance care planning with family carers in dementia nursing homes: A paired cluster randomized controlled trial;Brazil,2018

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