Universität zu Köln

Silies, Katharina Theodora, Koepke, Sascha and Schnakenberg, Rieke . Informal caregivers and advance care planning: systematic review with qualitative meta-synthesis. BMJ Support. Palliat. Care. LONDON: BMJ PUBLISHING GROUP. ISSN 2045-4368

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Abstract

Background Advance care planning (ACP) is a communication process about a person's values, life goals and preferences for current and future treatment and care. It can improve end-of-life care experiences for care recipients as well as for family caregivers. Knowledge about caregivers' needs might support implementation of ACP interventions suitable to both care recipients and their caregivers. Objective To explore the experiences and attitudes of informal family caregivers, and their knowledge, regarding ACP. Methods A systematic literature search was conducted (participants: family caregivers; intervention: advance care planning; databases: MEDLINE, PsycINFO, CINAHL, Cochrane Library). Thematic synthesis was applied to qualitative and mixed methods studies; quantitative studies were described in relation to the themes of the meta-synthesis. Results 57 studies were included, of these 51 in the meta-synthesis. Three themes emerged: (1) caregiver's individual conceptualisation of ACP, (2) caregiver's relationships and (3) ACP process. These themes were incorporated into a longitudinal perspective on the caregiver's ACP trajectory, encompassing the phases (A) life before, (B) ACP process, (C) utilisation of ACP and (D) life after. The implications for ACP activities are described according to each phase. Conclusion For the benefit of care recipients, healthcare professionals should carefully consider caregivers' conceptualisations of ACP as well as the relationships within the family. They need to be skilled communicators, sensitive to individual needs and equipped with sufficient time resources to tailor ACP interventions to their clients' unique situation. Thus, they will support decision-making according to care recipients' wishes, caregivers' end-of-life experience and their life after bereavement. PROSPERO registration number CRD42018082492.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Silies, Katharina Theodora UNSPECIFIED UNSPECIFIED UNSPECIFIED Koepke, Sascha UNSPECIFIED UNSPECIFIED UNSPECIFIED Schnakenberg, Rieke UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-582950
DOI:	10.1136/bmjspcare-2021-003095
Journal or Publication Title:	BMJ Support. Palliat. Care
Publisher:	BMJ PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	2045-4368
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language OF-LIFE CARE; FAMILY CAREGIVERS; DECISION-MAKING; OLDER-PEOPLE; DIALYSIS PATIENTS; CONTROLLED-TRIAL; END; DEMENTIA; PATIENT; VIEWS Multiple languages Health Care Sciences & Services Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/58295