Article Text
Abstract
Introduction Community rates of Advance Care Planning (ACP) remain low. Eighty-five percent of Australians believe in the importance of discussing their end-of-life care preferences, however, only one third of Australians have had a conversation with family members. Advance Directive/Advance Health Directive completion rates are even lower; 14% for Australians and 7.5% for Western Australians. We hypothesised that community-based, facilitated ACP workshops would: improve participants’ knowledge of ACP, increase the number of conversations regarding end-of-life care preferences, and increase participants’ completion of documentation.
Methods The workshops drew upon the transtheoretical and the behaviour change models. Three hundred and forty- two participants completed the workshops aged 43–94 years (M = 73.05, SD = 8.96). Seventy-two percent of the sample were women, 59.1% resided in metropolitan Perth, 59.2% were born in Australia, and 81.7% were retired. More than half of the participants were married or in a de facto relationship (60.2%), 53% of participants had post high school qualifications, and 39.5% were living with a chronic illness. We collected data using a pre-test post-test research design at two time points, directly prior to the workshop and three months post workshop. We analysed the data using the Generalised Linear Mixed Model.
Findings We found that participants improved their knowledge of Advance Care Planning concepts and were more likely to complete end-of-life documents (Advance Care Plan, Advance Health Directive) and appoint an Enduring Power of Attorney and an Enduring Power of Guardianship.
Conclusion Our findings suggest that theoretically based ACP workshops can ensure family members and health professionals are aware of a person’s end of life preferences. These workshops have the potential to prevent burdensome treatments, and to support individuals, families and the health system. Future research could use an experimental design and assess self-efficacy, attitudes, depth of conversations, and where documents are kept.