Shu-Chen Wanga, b, c, Chih-Jung Changa, Sheng-Yu Fand, Ying-Wei Wange, f, Shu-Chuan Changa, c, Huei-Chuan Sungg
a Department of Nursing, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
b School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
c Department of Nursing, Tzu Chi University, Hualien, Taiwan
d Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
e Department of Family Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
f Department of Medicine, Tzu Chi University, Hualien, Taiwan
g Department of Nursing, Tzu Chi College of Technology, Hualien, Taiwan
Abstract
Objectives
Advance care planning (ACP) is the process of discussing the wishes of people regarding end-of-life care and other related medical decisions. The aims of this study were to develop an ACP booklet in Taiwan and to identify relevant ACP issues.
Materials and methods
A three-stage research design was used. First, potential items were collected from the literature and were modified based on clinical situations and Taiwanese culture. Next, experts in palliative care evaluated the content validity of the items. Finally, healthy participants reviewed the ACP booklet and then discussed their experiences in focus groups.
Results
The significant issues identified discussing ACP included life story, current health status and habits, life-threatening conditions and suffering, medical decisions about the end-of-life care, and a number of other items. The provision of comprehensive information about the pros and cons of specific medical procedures and of palliative care was identified as important.
Conclusion
An ACP booklet facilitates discussion and decision-making related to end-of-life care. Furthermore, the present findings indicated that, when carrying out an ACP discussion, not only are the preferences and values of people important, but also factors related to their culture.
Keywords
ACP; Advance care planning; Communication; End-of-life care; Taiwan
