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Advance Care Planning in Asia: A Systematic Narrative Review of Healthcare Professionals’ Knowledge, Attitude, and Experience
- Source :
- Journal of the American Medical Directors Association, 22(2), 349.e1-349.e28. Elsevier Inc.
- Publication Year :
- 2021
-
Abstract
- Objective: The value of advance care planning (ACP) for patients with life-limiting illnesses is widely recognized but Asian health care professionals' (HCPs') perspectives on ACP have received little systematic attention. We aim to synthesize evidence regarding Asian HCPs’ knowledge of, attitudes toward, and experiences with ACP. Design: Systematic review with narrative synthesis and stepwise thematic analysis. Setting and Participants: HCPs in southern, eastern, and southeastern Asia. Methods: Studies from inception to September 2019 were identified from English-language searches of Embase, MEDLINE, Web of Science, and Google Scholar with reference-chaining and hand-searching. Two investigators independently screened and assessed the risk of bias in all original studies reporting HCPs’ knowledge of, attitudes toward, and experiences with ACP, including their perspectives toward barriers and facilitators of ACP. Results: Fifty-one studies were included; 42 were quantitative, 43 had been conducted in high-income countries, and 36 were of good quality. Twenty-six studies operationalized ACP as the completion of an advance directive rather than a value-exploration process. Thirteen studies reported knowledge, 44 attitudes, 29 experiences, and 36 barriers and facilitators of ACP. Asian HCPs addressed the essential role of families in ACP. They acknowledge the importance of ACP but rarely engage the patient in it. They considered ACP difficult to initiate, partly because of their lack of knowledge and skills in ACP, personal uneasiness to conduct ACP, fear of conflicts with family members and their legal consequences, and the lack of a standard system for ACP. Most studies indicated HCPs’ low engagement and late initiation of ACP. Conclusions and Implications: Despite acknowledging its importance, Asian HCPs felt that engaging in ACP is challenging. Capacity building for ACP in Asia should focus on culturally adapting ACP models concerning the essential role of the family in Asia, education for HCPs and the public, and providing institutional support for ACP.
- Subjects :
- Advance care planning
Health Knowledge, Attitudes, Practice
Asia
animal structures
Health Personnel
education
MEDLINE
Advance Care Planning
03 medical and health sciences
0302 clinical medicine
Nursing
stomatognathic system
SDG 3 - Good Health and Well-being
Health care
Humans
Medicine
Narrative
030212 general & internal medicine
General Nursing
Operationalization
business.industry
Health Policy
Capacity building
General Medicine
Directive
humanities
bacteria
Geriatrics and Gerontology
Thematic analysis
Advance Directives
business
030217 neurology & neurosurgery
Subjects
Details
- Language :
- English
- ISSN :
- 15258610
- Volume :
- 22
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Journal of the American Medical Directors Association
- Accession number :
- edsair.doi.dedup.....491b6d93479126be9051b404b5260047