Abstract
BackgroundAdvance care planning is a process of discussion that enables competent adults to express their wishes about end-of-life care through periods of decisional incapacity. Although a number of studies have documented social workers’ attitudes toward, knowledge about, and involvement in advance care planning, the information is fragmented. The purpose of this review was to provide a narrative synthesis of evidence on social workers’ perspectives and experiences regarding implementation of advance care planning.MethodsSix databases were searched for peer-reviewed research papers from their respective inception through December 2016. All of the resulting studies relevant to both advance care planning and social worker were examined. The findings of relevant studies were synthesized thematically.ResultsThirty-one articles met the eligibility criteria. Six research themes were identified: social workers’ attitudes toward advance care planning; social workers’ knowledge, education and training regarding advance care planning; social workers’ involvement in advance care planning; social workers’ perceptions of their roles; ethical issues relevant to advance care planning; and the effect of social work intervention on advance care planning engagement. The findings suggest that there is a consensus among social workers that advance care planning is their duty and responsibility and that social workers play an important role in promoting and implementing advance care planning through an array of activities.ConclusionsThis study provides useful knowledge for implementing advance care planning through illustrating social workers’ perspectives and experiences. Further studies are warranted to understand the complexity inherent in social workers’ involvement in advance care planning for different life-limiting illnesses or within different socio-cultural contexts.
Highlights
Advance care planning is a process of discussion that enables competent adults to express their wishes about end-of-life care through periods of decisional incapacity
Sixteen descriptive studies included a sample of only social workers [11, 19, 20, 22, 24, 25, 35,36,37,38,39,40,41,42,43,44]
Four included social workers recruited from hospitals, additional four included social workers from nursing homes, two included social worker students, and the remaining six included a mixed sample of social workers (Table 1)
Summary
Advance care planning is a process of discussion that enables competent adults to express their wishes about end-of-life care through periods of decisional incapacity. ACP is a voluntary process of discussion that extends the rights of competent adults and enables them to express or communicate their wishes about future health care through periods of decisional incapacity [3, 10, 11]. During this process, ADs may or may not be formulated, which are “a person’s verbal or written expression or instructions about his or her wishes, preferences, or plans for future medical treatments or health care, in the event that he/she becomes unable to communicate” [3, 10]. ACP increased the completion of ADs, concordance between preferences for care and delivered care, and likelihood of improvement of other outcomes for patients and their loved ones [15]
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