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- Title
Knowledge and Attitudes of Allied Health Professionals Towards End-Of-Life and Advance Care Planning Discussions With People With COPD: A Cross-Sectional Survey Study.
- Authors
Disler, Rebecca; Henwood, Brooke; Luckett, Tim; Pascoe, Amy; Donesky, Doranne; Irving, Louis; Currow, David C; Smallwood, Natasha
- Abstract
Chronic obstructive pulmonary disease (COPD) is a progressive, life-limiting condition. End-of-life (EOL) and Advance Care Planning (ACP) discussions are essential, yet access and support remain inadequate. Allied health professionals (AHPs) commonly have ongoing relationships with patients and opportunities to discuss care outside acute crises as is considered best practice. Australian and New Zealand AHPs were invited to complete an anonymous, online, cross-sectional survey that aimed to explore knowledge, attitudes and practices, and associated perceived triggers and barriers to EOL and ACP discussions with patients with COPD. Closed survey responses were summarized descriptively and free-text thematically analysed. One hundred and one AHPs (physiotherapists, social workers and occupational therapists) participated. Many held positive attitudes towards ACP but lacked procedural knowledge. Half (50%) of participants routinely discussed EOL care with patients when perceiving this to be appropriate but only 21% actually discussed ACP with the majority of their patients. Many cited lack of training to engage in sensitive EOL discussions, with barriers including: 1) clinician lack of confidence/fear of distressing patients (75%); 2) perceived patient and family reluctance (51%); 3) organizational challenges (28%); and 4) lack of role clarity (39%). AHPs commonly have ongoing relationships with patients with chronic conditions but lack the confidence and role clarity to utilise this position to engage ongoing EOL and ACP discussions. While AHPs may not traditionally consider EOL and ACP discussions as part of their role, it is crucial that they feel prepared to respond if patients broach the topic.
- Subjects
NEW Zealand; AUSTRALIA; PROFESSIONS; TERMINAL care; HEALTH services accessibility; CONFIDENCE; ATTITUDES of medical personnel; SOCIAL workers; CROSS-sectional method; RESEARCH methodology; FEAR; POPULATION geography; ADVANCE directives (Medical care); SURVEYS; COMPARATIVE studies; ORGANIZATIONAL change; OBSTRUCTIVE lung diseases; DESCRIPTIVE statistics; RESEARCH funding; PATIENT-professional relations; EXERCISE physiologists; THEMATIC analysis; ALLIED health personnel; PALLIATIVE treatment
- Publication
American Journal of Hospice & Palliative Medicine, 2023, Vol 40, Issue 8, p856
- ISSN
1049-9091
- Publication type
Article
- DOI
10.1177/10499091221134777