Primary Care Professionals' Self-Efficacy Surrounding Advance Care Planning and Its Link to Sociodemographics, Background and Perceptions: A Cross-Sectional Study.

Cristina Lasmarías,Esther Limón,Francisco Cegri,Cristina Esquinas,Mireia Subirana-Casacuberta,Sebastià Santaeugènia,Amor Aradilla-Herrero

doi:10.3390/ijerph18179034

Abstract

Primary care (PC) professionals have been considered the most appropriate practitioners for leading Advance care planning (ACP) processes with advanced chronic patients. Aim: To explore how PC doctors’ and nurses’ self-efficacy surrounding ACP is linked to their sociodemographic characteristics, background and perceptions of ACP practices. Methods: A cross-sectional study was performed. Sociodemographics, background and perceptions about ACP in practice were collected using an online survey. The Advance Care Planning Self-Efficacy Spanish (ACP-SEs) scale was used for the self-efficacy measurement. Statistical analysis: Bivariate, multivariate and backward stepwise logistic regression analyses were performed to identify variables independently related to a higher score on the ACP-SEs. Results: N = 465 participants, 70.04% doctors, 81.47% female. The participants had a mean age of 46.45 years and 66.16% had spent >15 years in their current practice. The logistic regression model showed that scoring ≤ 75 on the ACP-SEs was related to a higher score on feeling sufficiently trained, having participated in ACP processes, perceiving that ACP facilitates knowledge of preferences and values, and perceiving that ACP improves patients’ quality of life. Conclusion: Professionals with previous background and those who have a positive perception of ACP are more likely to feel able to carry out ACP processes with patients.

Highlights

Advance care planning (ACP) enables individuals to define goals, values, and preferences for future medical treatment and care, to discuss these matters with their family and care providers, and to record and review preferences as necessary [1]
A total of 465 professionals participated in the study, of whom 70.04% were doctors and 29.96% were nurses
The factors related to greater self-efficacy in ACP are associated with considering oneself to be sufficiently trained in ACP, having previously participated in ACP processes, believing that ACP can contribute to improving the quality of life of the people cared for and believing that ACP

Summary

Introduction

Advance care planning (ACP) enables individuals to define goals, values, and preferences for future medical treatment and care, to discuss these matters with their family and care providers, and to record and review preferences as necessary [1]. Initiatives have explored, for instance, the factors that make ACP processes feasible in daily practice [2], the main benefits for patients and families [3] and the health outcomes expected from an ACP process [4,5]. In this sense, proposals about how to integrate models of ACP into health systems [6,7,8] and how to adapt ACP content to individuals’ health condition [9] and to specific settings [10,11] have been studied.

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Discussion

Conclusion