Abstract
Background: Provision of advance care planning (ACP) in patients with cardiovascular diseases is suboptimal in South Korea, which leads to an increase in the burden of care. Healthcare professionals’ perspectives of ACP are particularly important to facilitate its utilization. However, Korean healthcare professionals’ perspectives on ACP remain unknown. Aim: We explored perspectives and attitudes regarding ACP among healthcare professionals (physicians and nurses) who provide care to patients with cardiovascular diseases, using a Q methodology. Methodology: The Q sample consisted of 40 statements representing perspectives for and attitudes toward ACP derived from a literature review, mass media reports, and an in-depth qualitative interview. P samples consisted of 10 physicians and 14 nurses. The P sample filled each grid with a statement in the Q sorting table. Data were analyzed using the PQ Method program. Results: Seventy-one percent of the variance was explained with four factors represented by 18 Q – sorters, with each variance explained by each factor ranging from 16% to 20%: Factor A (n=5), healthcare professional-led decision about ACP; Factor B (n=5), patient value-based persuasive decision about ACP; Factor C (n=5), prognosis-based passive support for ACP; Factor D (n=3), comprehensive consideration -induced decision for ACP. Six Q-sorters fell into either confounded or non-significant. Shared perspectives for ACP among Korean healthcare professionals emerged in areas including conceptual definition, educational support and training, and ethical and legal concerns, while each factor also presented unique and primary perspectives for ACP. Conclusions: Our research revealed shared and unique perspectives for ACP in Korean healthcare professionals who treat cardiac patients. The findings of this study provide basic data for the provision of ACP in which, as a major stakeholder, healthcare providers’ perspectives should be considered in educational support and training. Keywords: advance care planning; cardiac disease; nurse; physician; perspectives; Q methodology
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