Advance care planning engagement in patients with chronic, life-limiting illness: baseline findings from a cluster-randomised controlled trial in primary care

Julie Stevens; Rose Miranda; Luc Deliens; Peter Pype; Aline De Vleminck; Koen Pardon

doi:10.3399/BJGP.2022.0100

Published eLetters

eLetter submission guidelines

Submit a Response to This Article

Compose eLetter

Title *

Author Information

Contributors

First Name and Middle Initial *

First or given name, e.g. 'Peter'.

Last Name *

Your last, or family, name, e.g. 'MacMoody'.

Email Address *

Your email address, e.g. higgs-boson@gmail.com. PLEASE NOTE: your email address will be published.

Occupation *

Your role and/or occupation, e.g. 'Orthopedic Surgeon'.

Affiliation *

Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.

Statement of Competing Interests

Competing interests? *

Yes

Please describe the competing interests

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

Jump to comment:

Education for advanced care planning respecting cultural and social sensitivity
Ryuichi Ohta

Published on: 24 May 2023

Published on: (24 May 2023)
Page navigation anchor for Education for advanced care planning respecting cultural and social sensitivity
Education for advanced care planning respecting cultural and social sensitivity
Ryuichi Ohta, Family physician, Unnan City Hospital, Japan
I have read, with great respect, the research titled “Advance care planning engagement in patients with chronic, life-limiting illness: baseline findings from a cluster-randomised controlled trial in primary care.”¹ This research clarified what GPs should emphasize for effective improvement of patients engagement in advanced care planning (ACP). The critical factor is discussing with patients about their future health, such as controlling their symptoms in palliative status. As GPs need active listening skills to facilitate ACP, communication training specific to ACP should be established and investigated regarding the effectiveness.

Furthermore, ACP education should be nuanced, respecting cultural and social backgrounds. In Asian contexts, ACP among older patients may depend on physicians’ perspectives and not be motivated to decide where to live in terminal conditions.² There may be the social norm that all of the physicians’ decisions are reliable because of already established paternalism among older generations. Another factor affecting ACP among older people is caregiver issues. In Japan, caregivers’ burden is critical because fewer people are dedicated to caregiving, and more people work outside their houses, causing the lack of a caregiving workforce.³ The practical education of ACP to general practitioners and patients should include more about social and cultural issues in addition to communic...
Show More

I have read, with great respect, the research titled “Advance care planning engagement in patients with chronic, life-limiting illness: baseline findings from a cluster-randomised controlled trial in primary care.”¹ This research clarified what GPs should emphasize for effective improvement of patients engagement in advanced care planning (ACP). The critical factor is discussing with patients about their future health, such as controlling their symptoms in palliative status. As GPs need active listening skills to facilitate ACP, communication training specific to ACP should be established and investigated regarding the effectiveness.

Furthermore, ACP education should be nuanced, respecting cultural and social backgrounds. In Asian contexts, ACP among older patients may depend on physicians’ perspectives and not be motivated to decide where to live in terminal conditions.² There may be the social norm that all of the physicians’ decisions are reliable because of already established paternalism among older generations. Another factor affecting ACP among older people is caregiver issues. In Japan, caregivers’ burden is critical because fewer people are dedicated to caregiving, and more people work outside their houses, causing the lack of a caregiving workforce.³ The practical education of ACP to general practitioners and patients should include more about social and cultural issues in addition to communication methods. Further investigation can include how such issues affect ACP decision-making and the educational effects.

References

1. Stevens J, Miranda R, Deliens L, Pype P, De Vleminck A, Pardon K. Advance care planning engagement in patients with chronic, life-limiting illness: baseline findings from a cluster-randomised controlled trial in primary care. Br J Gen Pract 2023;73(730): e384-e391. DOI: 10.3399/BJGP.2022.0100.
2. Ohta R, Ryu Y, Kitayuguchi J, Gomi T, Katsube T. Challenges and solutions in the continuity of home care for rural older people: A thematic analysis. Home Health Care Serv Q 2020;39(2):126-139. DOI: 10.1080/01621424.2020.1739185.
3. Imaiso J, Sasaki U. Influential factors of long-term care in a Japanese rural community examined through interviews of family caregivers. J Community Health Nurs 2010;27(1):23-31. DOI: 10.1080/07370010903466148.
Show Less

Competing Interests: None declared.