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Prof. Dr. JinShil Kim

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Guest Editor

Gachon University, College of Nursing, Dept. Of Nursing (21936) 191 Hambakmoero, Yeonsu-gu, Incheon, Korea
Interests: nursing, public health, interprofessional care

Prof. Dr. Minjeong An

E-Mail Website
Guest Editor

Chonnam National University College of Nursing (61469) 160 Baekseoro, Donggu, Gwangju, Korea
Interests: nursing; public health; interprofessional care

Special Issue Information

Dear Colleagues,

Longer life with multiple chronic conditions is becoming increasingly burdensome to elderly people as well as current society. Despite therapeutic advances, chronic progressive illness still involves high morbidity and mortality. Under the circumstances of living with the deteriorating course of the illness, chronically ill people and/or their families who may or may not have life-limiting conditions are often exposed to a spectrum of decision-making situations for medical care. Early introduction to advance care planning (ACP) could enhance informed and shared decision making regarding future medical care through ongoing communication with healthcare providers and families. People may also prepare an advance directive (AD) in which preferred care at the end-of-life can be stated ahead of time. Despite the clinical benefits of ACP and/or ADs, such as less resource utilization near death and more palliative consultation and hospice care referrals, suboptimal utilization is still of concern.

Thus, we welcome papers focusing on but not limited to the associated outcomes of ACP or written ADs, patient and caregiver satisfaction, reduced unnecessary costs, and quality of end-of-life care. Papers exploring socio-cultural perspectives for ACP and/or ADs are also welcome. Suitable submissions include a variety of article types: original research papers (qualitative research, quantitative research, and mixed methods research), review articles, book reviews, and opinion pieces from researchers interested in this research topic.

Prof. Dr. JinShil Kim
Prof. Dr. Minjeong An
Guest Editors

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Keywords

advance care planning
advance directive
palliative care
hospice care
end-of-life
terminal
communication
Physician Orders for Life-Sustaining Treatment (POLST)

Published Papers (2 papers)

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Research

15 pages, 362 KiB

Open AccessArticle

Exploring Differential Perceptions and Barriers to Advance Care Planning in Dementia among Asian Patient–Caregiver Dyads—A Mixed-Methods Study

by Noorhazlina Ali, Philomena Anthony, Wee Shiong Lim, Mei Sian Chong, Edward Wing Hong Poon, Vicki Drury and Mark Chan

Int. J. Environ. Res. Public Health 2021, 18(13), 7150; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18137150 - 04 Jul 2021

Cited by 9 | Viewed by 3344

Abstract

A parallel mixed-methods study on 20 patient–caregiver dyads in an Asian population was conducted to explore the differential perceptions and barriers to ACP in dementia. We recruited English-speaking patients with mild dementia and their caregivers. A trained ACP facilitator conducted ACP counseling. Patient–caregiver dyads completed pre–post surveys and participated in post-counseling qualitative interviews. We used mixed-methods analysis to corroborate the quantitative and qualitative data. Differential perceptions of ACP were reported among dyads, with caregivers less inclined for further ACP discussions. Post-ACP counseling, caregivers were significantly more likely to acknowledge barriers to ACP discussions than patients (57.9% versus 10.5%, p = 0.005). Thematic analysis of the interview transcripts revealed four themes around barriers to ACP: patient-related factors (transference of decision making, poor cognition and lack of understanding, and dis-inclination to plan for the future), caregiver-related factors (perceived negative impact on the patient, caregiver discomfort, and confidence in congruent decision making), socio-cultural factors (taboos, superstitions, and religious beliefs), and the inappropriate timing of discussions. In a collectivist Asian culture, socio-cultural factors pose important barriers, and a family-centric approach to initiation of ACP may be the first step towards engagement in the ACP process. For ACP in dementia to be effective for patients and caregivers, these discussions should be culturally tailored and address patient, caregiver, socio-cultural, and timing barriers. Full article

(This article belongs to the Special Issue The Effects of Advance Care Planning in Healthcare)

12 pages, 342 KiB

Open AccessArticle

Advance Directives and Factors Associated with the Completion in Patients with Heart Failure

by JinShil Kim, Mi-Seung Shin, Albert Youngwoo Jang, Shinmi Kim, Seongkum Heo, EunSeok Cha and Minjeong An

Int. J. Environ. Res. Public Health 2021, 18(4), 1780; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18041780 - 12 Feb 2021

Cited by 3 | Viewed by 2213

Abstract

Advance directive (AD) has been underutilized among patients with heart failure (HF). This study was performed to explore the ADs and examine factors associated with the completion of an AD survey in patients with HF. In a descriptive, correlational study, data on end-of-life values, treatment directives, and proxy (Korean-Advance Directive (K-AD) questionnaire) and factors associated with K-AD completion were collected among HF patients during outpatient visits. Of 67 patients (age, 67 years; male, 61.2%), 52.2% completed all or part of the K-AD. Among values, comfortable death was the most preferred (n = 15) followed by avoiding family burden (n = 6). In those completers, preferences for hospice care, cardiopulmonary resuscitation, ventilation support, and hemodialysis were 68.6%, 42.9%, 28.6%, and 28.6%, respectively. Female sex (odds ratio (OR) = 0.167), poorer HF prognosis (OR = 0.156), and better functional status (OR = 0.905) were associated with less likelihood of completing the AD survey. The findings suggest that in-depth AD discussion needs to be started earlier in patients with HF to facilitate completion of AD, especially in female patients. Future research should investigate if early discussion of ADs as part of advance care planning with integration into standard care of HF facilitates the documentation of ADs. Full article

(This article belongs to the Special Issue The Effects of Advance Care Planning in Healthcare)

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