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PERCEPTIONS OF BENEFITS AND BARRIERS IN CONDUCTING ADVANCE CARE PLANNING: A CROSS-SECTIONAL SURVEY OF TRAINED ADVANCE CARE PLANNING FACILITATORS
  1. R Ng1 and
  2. R Chong2
  1. 1Department of Palliative Medicine, 2Operations Community. Tan Tock Seng Hospital, Singapore
  2. 2Tan Tock Seng Hospital, Operations Community, Singapore

Abstract

Background Since 2010, within Tan Tock Seng Hospital (TTSH), pilot projects in advance care planning (ACP) were initiated with patients with chronic disease, organ failure and advanced illnesses such as terminal cancer.

Aim To evaluate the attitudes and perceptions of trained ACP facilitators in TTSH.

Method An anonymous cross-sectional survey in the form of a questionnaire was administered to all certified ACP facilitators in the hospital.

Results A total of 59 trained facilitators, comprising nurses (36%), doctors (29%), medical social workers (25%) and case managers (8%) responded to the survey. Majority (95%) of respondents favour ACP and 86% consider ACP as one of their roles. More than 90% respondents felt that ACP promotes patient-centred care, improves communication, and reduces burden of decision making on families. Most of the time (53%), initiation of ACP was by doctors.

90% respondents felt that ACP is challenging to conduct. Major barriers to conducting ACP are lack of time (66%), perception of low receptivity to ACP in patients' families (53%), patients' lack of understanding of ACP (50%) as well as language barriers (48%).

Discussion While the attitudes of trained facilitators towards ACP are largely positive, there are significant barriers to ACP facilitation, namely a lack of time.

Conclusion Whilst it helps to spread advocacy for and practice of ACP in training facilitators from multiple healthcare disciplines, there is also a need for careful consideration of resource allocation such as dedicated ACP facilitators, for successful implementation of ACP.

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