How can advance care planning support hope in patients with advanced cancer and their families: A qualitative study as part of the international ACTION trial

Kodba-Čeh, Hana; Lunder, Urška; Bulli, Francesco; Caswell, Glenys; van Delden, Johannes J. M.; Kars, Marijke C.; Korfage, Ida J.; Miccinesi, Guido; Rietjens, Judith A.C.; Seymour, Jane; Toccafondi, Alessandro; Zwakman, Marieke; Pollock, Kristian; ACTION Consortium

Abstract

Objective: Clinicians' fears of taking away patients' hope is one of the barriers to advance care planning (ACP). Research on how ACP supports hope is scarce. We have taken up the challenge to specify ways in which ACP conversations may potentially support hope. Methods: In an international qualitative study, we explored ACP experiences of patients with advanced cancer and their personal representatives (PRs) within the cluster-randomised control ACTION trial. Using deductive analysis of data obtained in interviews following the ACP conversations, this substudy reports on a theme of hope. A latent thematic analysis was performed on segments of text relevant to answer the research question. Results: Twenty patients with advanced cancer and 17 PRs from Italy, the Netherlands, Slovenia, and the United Kingdom were participating in post-ACP interviews. Three themes reflecting elements that provide grounds for hope were constructed. ACP potentially supports hope by being (I) a meaningful activity that embraces uncertainties and difficulties; (II) an action towards an aware and empowered position; (III) an act of mutual care anchored in commitments. Conclusion: Our findings on various potentially hope supporting elements of ACP conversations provide a constructive way of thinking about hope in relation to ACP that could inform practice.

Citation

Kodba-Čeh, H., Lunder, U., Bulli, F., Caswell, G., van Delden, J. J. M., Kars, M. C., …ACTION Consortium. (2022). How can advance care planning support hope in patients with advanced cancer and their families: A qualitative study as part of the international ACTION trial. European Journal of Cancer Care, 31(6), Article e1371. https://doi.org/10.1111/ecc.13719

• Journal Article Type: Article
• Acceptance Date: Sep 14, 2022
• Online Publication Date: Sep 27, 2022
• Publication Date: 2022-11
• Deposit Date: Nov 30, 2022
• Publicly Available Date: Dec 2, 2022
• Journal: European Journal of Cancer Care
• Print ISSN: 1365-2354
• Electronic ISSN: 1365-2354
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 31
• Issue: 6
• Article Number: e1371
• DOI: https://doi.org/10.1111/ecc.13719
• Keywords: Advance care planning, cancer, end of life, hope, international, qualitative research
• Public URL: https://nottingham-repository.worktribe.com/output/12022683
• Publisher URL: https://onlinelibrary.wiley.com/doi/10.1111/ecc.13719