Interdisciplinary Focus Groups Research Articles

How to meet coping strategies and preferences of children during invasive medical procedures: perspectives of healthcare professionals

Children with negative procedural experiences have an increased risk of fear and distress, with psychological consequences for subsequent procedures and future healthcare behaviors. Gaining control and feeling trust are important aspects for children to decrease fear. To enable professionals providing personal care during medical procedures, a systematic, evidence-based approach that supports children in expressing their preferences is needed. This study will gain insight into the experiences and needs of professionals involved in small invasive medical procedures to meet the coping strategies and preferences of children undergoing these procedures. A qualitative design was used to gain insight into professionals’ perspectives. Data were collected through online focus groups with various professionals involved in medical procedures, such as anesthetists, laboratory staff, nurses, and pediatricians. Five interdisciplinary focus groups, with a total of 32 participants, were held. One overarching theme was revealed: “Balancing between different actors within the context of the hospital.” Professionals reported they had to deal with different actors during a medical procedure: the child, the parent, the colleague, and themselves. Each actor had its own interests. They were aware of the child and parents’ priority to gain control and feel trust. Nevertheless, they perceive organizational and personal aspects that hinder addressing these needs. Conclusion: To provide personalized care, professionals experience balancing between the needs and interests of diverse actors during medical procedures. The findings underscore the importance of a policy supporting HCPs in integrating patient-centered care into practice through practical tools and training initiatives such as scenario training.What is Known:• Unresolved pain and stress arising from medical procedures can have significant short- and long-term impacts on children. Empowering children to gain control and fostering a sense of trust are crucial factors in reducing fear associated with medical procedures.• Children and parents expect to receive child-tailored care from professionals including respect for their own, unique needs, and boundaries. Professionals should build trustful relationships and provide appropriately tailored autonomy around medical procedures.What is New:• Healthcare professionals vary in their awareness of children’s needs during a medical procedure. Beside this, the organizational dynamics of the hospital, along with the presence of actors such as the child, parent, colleague, and oneself, collectively influence the conduct of medical procedures.• Providing person-centered care during medical procedures can present challenges. The results highlight the significance of a policy to assist healthcare professionals in incorporating patient-centered care into their practice through practical tools and a culture of self-reflections regarding patient-centered values.

Blueprint Persona and ICT Interventions: Addressing Unmet Needs in Burning Mouth Syndrome Care

ObjectivesThis study aimed to create a Blueprint Persona for Burning Mouth Syndrome (BMS) patients, focusing on unmet needs that digital solutions can address. MethodsAn interdisciplinary focus group formulated the BMS Blueprint Persona by discussing clinical data and survey results regarding education, informatics skills, and perceived unmet needs, collected from 500 BMS patients between 2022 and 2023. ResultsThe BMS Blueprint Persona, named Anna, represents a typical BMS patient profile: a young-old woman with limited computer skills who experiences anxiety, depression, and insomnia, has memory issues leading to medication adherence challenges, is obese due to overeating, and spends much time watching TV at home. Anna's primary concern is receiving inadequate treatment and not achieving disease remission. She also feels misunderstood and lacks family support. This persona reveals several areas where Information and Communication Technology (ICT) interventions, like telemedicine, anxiety and insomnia treatment, drug adherence improvement, and nutritional and lifestyle guidance, could be beneficial. The focus group also outlined the essential features for a prospective mHealth app to meet BMS patients' diverse needs. ConclusionThe development of the BMS Blueprint Persona successfully identified patient characteristics and unmet needs, offering valuable insights for creating personalized diagnostic-therapeutic pathways and digital health solutions for BMS.

Development, reliability, and validity assessment of a fall concerns scale for people who use wheelchairs and scooters (FCS-WC/S)

Purpose To evaluate the psychometric properties of a Fall Concerns Scale for people who use Wheelchairs and Scooters (FCS-WC/S). Materials and methods Developed by fall prevention experts, FCS-WC/S underwent refinement through interdisciplinary reviews and focus groups with researchers, clinicians, and individuals who use WC/S full-time. The psychometric evaluation involved adults who used WC/S for ≥1 year and had ≥1 fall in the previous 3 years, recruited between April and September 2022. Results The FCS-WC/S evaluates fall concerns among people with various health conditions who use WC/S full-time across 33 daily activities. One hundred and twenty-four participants responded to the baseline survey. A subgroup of 63 people repeated the FCS-WC/S a week later. The FCS-WC/S demonstrated excellent internal and good test–retest reliability (α ≥ 0.90, ICC = 0.86–0.9), as well as concurrent validity (Spearman’s rho = 0.72) with the Spinal Cord Injury Falls Concern Scale (SCI-FCS). It effectively differentiated fear of falling levels from an established measure (ORs 4.1, 25.8, 46.7). Factor and parallel analysis revealed three factors, two of which were retained for further analysis. Conclusions Preliminary findings support FCS-WC/S validity and reliability for assessing fall concerns among individuals with various conditions who use WC/S. Further scale construction analysis is recommended.

Understanding the Perspectives of Paediatric Physicians on Physiotherapy in Paediatric Rehabilitation in Chennai, India: A Qualitative Approach.

Children with disabilities may exhibit a multitude of symptoms, and treatment requires a multidisciplinary approach for a satisfactory outcome. Lack of awareness among physicians, lack of referral, and lack of inter-sectoral coordination have hindered paediatric practice in Tamil Nadu, a state in India with a striking childhood disability rate that warrants a timely interdisciplinary approach. However, the perspectives of paediatricians on paediatric physiotherapy are unknown. The aim of the study was to investigate the perspectives of practicing paediatric physicians in Chennai on the role of physiotherapy in paediatrics. For an in-depth exploration, qualitative semi-structured interviews were conducted in person with 10 paediatricians. Audio from the sessions was recorded and transcribed, and data saturation was achieved through iterative analysis. A grounded theory analysis of the results yielded 5 domains under which the perspectives and expectations of the physicians were described, along with the barriers experienced by patients' parents as explained by their paediatrician. The responses highlighted deficits in awareness, structural support, accessibility and direct communication between physicians and physiotherapists. Paediatric physicians have different opinions, and some ignorance persists concerning paediatric physiotherapy. This study warrants a proper structure of the paediatric rehabilitation unit and regular interdisciplinary meetings and focus group discussions to increase access for parents and improve patient outcomes.

Unveiling the Hidden Effects of Automated Vehicles on “Do No Significant Harm’’ Components

The deployment of automated vehicles (AVs) has the potential to disrupt and fundamentally transform urban transportation. As their implementation becomes imminent on cities’ streets, it is of great concern that no comprehensive strategies have been formulated to effectively manage and mitigate their potential negative impacts, particularly with respect to the components of the do no significant harm (DNSH) framework recently introduced in the EU taxonomy. The methodology employed comprises three steps: (i) An extensive literature review on the impact of AVs on the DNSH components; (ii) exploration of designing a coherent pro-active vision by integrating measures identified in the literature as key elements to mitigate the harm; and (iii) an interdisciplinary focus group (FG) to verify whether the impacts of AVs and potential mitigation measures for Bucharest are similar to those identified by the literature and integrated into the pro-active vision. The results suggest that while there are commonalities, variations exist in focus and perspective, underscoring the necessity of examining the mitigation measures encompassed in the vision through additional focus groups conducted in different cities.

Implikationen zur Verbesserung der Versorgungsqualität und -sicherheit von palliativen Bewohner*innen in der stationären Pflege: eine qualitative Studie

IntroductionDespite the increasing importance of palliative care, the implementation of professional and ethical quality standards appears to be challenging for nursing homes, leading to different levels of palliative care between facilities. This study aims to examine the concrete problem areas of palliative care in everyday practice and to discover what is needed to improve health care quality and patient safety of palliative residents in nursing homes from different perspectives. MethodsSemi-structured interviews with 14 employees and managers of two nursing homes in urban and rural areas in North Rhine-Westphalia were conducted and analyzed according to Mayring’s qualitative content analysis. Additionally, characteristics of ideal-typical palliative care in nursing homes were identified from different perspectives through interdisciplinary focus groups of various involved professions. ResultsDue to a lack of structural and organizational guidelines, processes of palliative care are based on subjective actions of the staff, which leads to uncertainties and differences in the management of palliative care for nursing home residents. Besides limited time resources for care and support of residents at their end of life, this represents a major stress factor for employees. In the focus groups, characteristics of ideal-typical palliative care in the everyday practice of palliative care were identified. In terms of potential for optimization, palliative care pathways are seen as one way to contribute to creating a framework for palliative processes which at the same time leaves room for professional decisions in individual cases. DiscussionIt seems likely that inconsistencies in the management of palliative care processes can also be found in other nursing homes. Indications of this include the low proportion of residents with identified palliative care needs and the lack of use of assessments to identify palliative needs and to monitor typical palliative symptoms. At the same time, it must be taken into account that the last phase of life is characterised by individuality, which cannot and should not be standardised. In palliative care practice, professional perceptions and empirical knowledge are well needed. Nevertheless, in terms of quality of care, these should not be the sole basis for palliative action. ConclusionDifferent levels of palliative care and employees’ uncertainties indicate that palliative care practice in nursing homes requires a framework that helps staff to act more confidently and yet leaves room for professional action and decision-making in individual cases.

Augmented reality in education for industry 4.0: What are the barriers to adoption?

One of the enabling technologies of Industry 4.0 is augmented reality. Augmented reality is currently supported on mobile devices and often does not require costly equipment, allowing it to expand quickly across industries such as entertainment and healthcare. Studies in education demonstrate that augmented reality can improve conceptual comprehension and learning in STEM fields and that educational organizations and teachers support its use. However, augmented reality is still used in only a few educational establishments. There have been few studies on the topic, raising concerns such as: what are the barriers to broader adoption of this technology? Understanding the issues better would allow educational organizations and instructors to take action to mitigate them. This study aims to identify and categorize the barriers, difficulties, and challenges for the adoption of augmented reality in education. The investigation was conducted in two stages: first, the barriers mentioned in 28 papers published in the Science Direct, Scielo, and Scopus databases were preliminary categorized, and then this categorization was validated by an interdisciplinary focus group of experts in education and industry 4.0. We identified seven categories as barriers to the adoption of augmented reality in education: technical, adoption, usability and user interaction, learning, pedagogical, financial, and technological nature. Our results contribute to mitigate these barriers and encourage actions to increase the potential of augmented reality in education.

Success Factors for Quality and Safety of Intensive Care Unit Transitional Care – Listening to the Sharp End

Purpose: The purpose of this paper was to present success factors for increasing quality and safety of intensive care unit (ICU) transitional care as described by co-workers at the sharp end using the core values of total quality management (TQM) as a theoretical lens. Methodology/Approach: The study had a qualitative design, with data from nine interdisciplinary focus group discussions, including co-workers from the intensive care and general wards. Data were sorted into TQM core values and analysed using qualitative content analysis. Findings: Quality and safety in transfer processes requires a holistic view, avoiding silos, shared arenas for collaboration, and evidence-based methodologies and tools for safe transfers. Research Limitation/Implication: A limitation of this study is that it only portrays the challenges encountered by two hospitals during the process of transitional care in the ICU. Originality/Value of paper: By using TQM core values as a theoretical lens, we could present a usable, holistic picture of success factors and how to improve the transfer process.

End-of-life decisions: A focus group study with German health professionals from human and veterinary medicine.

At first glance, human and (companion animal) veterinary medicine share challenging processes in end-of-life (EOL) decision-making. At the same time, treatment options in both professions are substantially different. The potential of an interdisciplinary exchange between both fields has been neglected by empirical research so far. In this qualitative study, professionals from both fields were brought together in interdisciplinary focus groups to investigate the ethical aspects of convergences and divergences in EOL situations in human and veterinary medicine. The authors present and discuss an innovative mix of materials and methods as stimuli for discussion and for generating hypotheses. The results point toward a general convergence of issues, challenges, and judgements in EOL situations in both fields, such as professional ethos, communication with the family and the role thereof as well as the ideals of death, clearly exceeding the expectations of study participants. At the same time, the study highlights a few prominent differences such as the access to patients' preferences or legal and practical constraints. The findings suggest that using social science methods in empirical interdisciplinary biomedical-veterinary ethics could help to shed more light on this new area. Animal as well as human patients can potentially benefit from this mutual, scientifically accompanied exchange and the resulting identification and corrections of misconceptions.

Ethical aspects of mechanical resuscitation in achild : Results of an expert workshop within the BMBF project CLAIRE-Children's Automated Intelligent Resuscitation

While the use of mechanical resuscitation devices can be considered for adult resuscitation, the European Resuscitation Council guidelines do not yet mention their use for pediatric resuscitation. Only one device has been partially approved for use in children; further pediatric appliances are currently being used off-label. Ethical considerations arising from the use of mechanical resuscitation devices have not yet been presented in astructured way. To elaborate ethical considerations in the development phase of mechanical resuscitation devices for children. Based on several fictitious case reports, an interdisciplinary expert focus group discussion was conducted. This was followed by amoderated discussion, summarizing the results. Guiding principles and research desiderata were formulated using these results as well as existing literature. According to the group of experts, ethical considerations regarding mechanical resuscitation devices in pediatrics predominantly concern the subject of indication and discontinuation criteria. Ethical aspects concerning psychosocial impacts on affected families and intervention teams cannot be generalized and need to be analyzed on acase-by-case basis. The considerations presented regarding the use of mechanical resuscitation devices in the pediatric context, which is still in its developmental stage, could also have practical implications for adult out-of-hospital resuscitation decisions. Concerning ethical aspects of out-of-hospital resuscitation decisions, especially using mechanical resuscitation devices, the need for accompanying empirical research is substantial.

Involvement of frontline clinicians in healthcare technology development: Lessons learned from a ventilator project

Co-development of healthcare technology with users helps produce user-friendly products, ensuring safe device usage and meeting patients’ needs. For developers considering healthcare innovations, engaging user experience can reduce production time and cost while maximizing device application. The purpose of this paper is to report lessons learned from the development of a 3D printed origami ventilator prototype in response to the rise of ventilator demand due to the Coronavirus disease (COVID-19) pandemic. We conducted focus groups with frontline clinicians working in an Intensive Care Unit of a large urban hospital in Vancouver, British Columbia, Canada. In the interdisciplinary focus groups, we identified challenges, practical tips about product development, the human needs of technology, and cross-discipline peer learning. The focus group discussions provide useful insight into the technology development for complex clinical contexts. Based on our experiences, we articulate five practical tips for co-development of healthcare technology - AGILE: Analyse users’ needs first, Gain insights into complex context, Involve users early and frequently, Lead with a prototype, and Educate and support. Through sharing the tips and lessons learned, we wish to emphasize the necessity of meaningful multi-disciplinary collaboration during healthcare technology development and promote the inclusion of frontline clinicians during these initiatives.

Development and evaluation of guidelines for prevention of retraumatisation in torture survivors during surgical care: protocol for a multistage qualitative study

IntroductionHealthcare professionals working in somatic departments are not trained to recognise signs of torture or provide appropriate healthcare to torture survivors, which may result in retraumatisation during surgical treatment.Methods and...

A co-design of clinical virtual care pathways to engage and support families requiring neonatal intensive care in response to the COVID-19 pandemic (COVES study)

BackgroundIn response to the COVID-19 pandemic, family presence restrictions in neonatal intensive care units (NICU) were enacted to limit disease transmission. This has resulted in communication challenges, negatively impacting family integrated care. AimTo develop clinical care pathways to ensure optimal neonatal care to support families in response to parental presence restrictions imposed during the COVID-19 pandemic. MethodsAn agile, co-design process utilizing expert consensus of a large interdisciplinary team and focus groups and semi-structured interviews with families and HCPs were used to co-design clinical virtual care pathways. ResultsThree clinical virtual care pathways were co-designed: (1) building and maintaining relationships between family and healthcare providers; (2) awareness of resources; and (3) standardized COVID-19 messaging. Modifications were made to optimize uptake and utilization in the clinical areas. ConclusionClinical care virtual pathways were successfully co-designed to meet these needs to ensure more equitable family centered care.

A Web-Based Application for Complex Health Care Populations: User-Centered Design Approach.

BackgroundAlthough eHealth technology makes it possible to improve the management of complex health care systems and follow up on chronic patients, it is not without challenges, thus requiring the development of efficient programs and graphic user interface (GUI) features. Similar information technology tools are crucial, as health care populations are going to have to endure social distancing measures in the forthcoming months and years.ObjectiveThis study aims to provide adequate and personalized support to complex health care populations by developing a specific web-based mobile app. The app is designed around the patient and adapted to specific groups, for example, people with complex or rare diseases, autism, or disabilities (especially among children) as well as Alzheimer or senile dementia. The app’s core features include the collection, labeling, analysis, and sorting of clinical data. Furthermore, it authorizes a network of people around the patient to securely access the data contained in his or her electronic health record.MethodsThe application was designed according to the paradigms of patient-centered care and user-centered design (UCD). It considers the patient as the main empowered and motivating factor in the management of his or her well-being. Implementation was informed through a family needs and technology perception assessment. We used 3 interdisciplinary focus groups and 2 assessment surveys to study the contexts of app use, subpopulation management, and preferred functions. Finally, we developed an observational study involving 116 enrolled patients and 253 system users, followed by 2 feedback surveys to evaluate the performance and impact of the app.ResultsIn the validated general GUI, we developed 10 user profiles with different privacy settings. We tested 81 functions and studied a modular structure based on disease or medical area. This allowed us to identify replicable methods to be applied to module design. The observational study not only showed good family and community engagement but also revealed some limitations that need to be addressed. In total, 42 of 51 (82%) patients described themselves as satisfied or very satisfied. Health care providers reported facilitated communication with colleagues and the need to support data quality.ConclusionsThe experimented solution addressed some of the health system challenges mentioned by the World Health Organization: usability appears to be significantly improved when the GUI is designed according to patients’ UCD mental models and when new media and medical literacy are promoted. This makes it possible to maximize the impact of eHealth products, thereby overcoming some crucial gaps reported in the literature. Two main features seemed to have potential benefit compared with other eHealth products: the modeling, within the app, of both the formal and informal health care support networks and the modular structure allowing for comorbidity management, both of which require further implementation.

Clinician Perspectives of Chronic Pain Management in Children and Adolescents with Cerebral Palsy and Dyskinesia

Aims To explore perspectives of clinicians from interdisciplinary teams on the barriers and facilitators to chronic pain management for children and adolescents with cerebral palsy and dyskinesia. Methods Interdisciplinary focus groups (n = 2) were conducted at two Australian tertiary pediatric hospitals. Twenty-five experienced clinicians took part, including ten physiotherapists, six pediatricians, four rehabilitation physicians, four occupational therapists, and one speech and language therapist. An external moderator conducted the focus groups and data were analyzed using inductive thematic analysis. Results Four key themes emerged: “balancing the intersection of pain and dyskinesia,” “difficulty communicating between so many providers,” “uncertainty surrounding chronic pain education,” and “differing priorities.” Key barriers were identified including a lack of access to some interdisciplinary team members and formalized guidance for health professionals regarding chronic pain education. Conclusion Key issues were reported to impact the delivery of coordinated inter-disciplinary chronic pain management at the tertiary level for children and adolescents with cerebral palsy and dyskinesia. In the absence of strong evidence, a strategy for implementing effective chronic pain management for children and adolescents with cerebral palsy and dyskinesia and gaining clinician consensus regarding the best practice management are recommended.

Digitizing Infectious Disease Clinical Guidelines for Improved Clinician Satisfaction.

The purpose of this project was to implement an improved rapid-deployment clinical decision support strategy for the detection and treatment of emerging and reemerging infectious diseases within an electronic health record informed by end-user satisfaction. After a review of the evidence and comprehensive workflow assessments, interdisciplinary focus groups were assembled to determine current infectious disease needs within the electronic health record and what guidance should be provided to clinicians to assist in making the best decisions for both patient care and population health. Education and reeducation issues were handled throughout the implementation process. Using the Plan-Do-Study-Act quality improvement framework for rapid cycle deployment, the design was implemented and monitored. To evaluate efficacy and clinician satisfaction of the implementation, presurvey and postsurvey measurements were employed. The Clinical Information System Implementation Evaluation Scale was used, along with demographic and qualitative textual questions, to evaluate clinician satisfaction. Findings indicate the implementation was successful (P < .05).

Clinical Pearls

Although the Institute of Medicine asserts that a palliative approach to care is needed to improve health care challenges, palliative principles have been difficult to incorporate in the intensive care unit (ICU). Critically ill patients often have unmet physical, psychological, emotional, and spiritual needs that could be identified with a palliative approach screening tool; however, no such tool has been designed for the ICU.Using interdisciplinary focus groups and surveys, Venis and Dodek developed and tested a screening tool specific for ICU use. They found thatBefore the tool was developed, members of the health care team showed a need for improved communication, collaboration, and a clearer understanding of what palliative care means for patients with poorer outcomes.The newly developed tool was considered easy to use and prompted a more timely and comprehensive approach to meeting palliative needs of patients and their families.To integrate the palliative approach and increase comfort with the tool, the authors recommend communication skills training and education about end-of-life care for clinicians.See Article, pp 214-220Family visitation in adult intensive care units (ICUs) has long been recognized as beneficial to patients and their families, including children. The American Association of Critical- Care Nurses (AACN) has published standards that enforce the positive outcomes of child visitation. However, the topic remains controversial, with some nurses feeling ill-prepared to manage children’s needs during visits.Desai et al surveyed adult ICU nurses to assess their perceptions and practices of child visitation. They foundThe authors express concern about the apparent lack of resources in adult ICUs for routine child visitation. They recommend education on the AACN standards and on existing research as well as enhancing resources for child visitors, including collaboration with child life specialists, to improve practice.See Article, pp 195-203Open visitation with unrestricted access to the patient can improve both family and patient outcomes. Although the American Association of Critical-Care Nurses (AACN) and the Society of Critical Care Medicine consider open visitation best practice, many adult intensive care units (ICUs) in the United States continue to have restrictive visiting.Milner and colleagues examined the visitation practices of 536 Magnet and Pathways to Excellence Programs (MPE) hospitals. They found the following:Although the number of hospitals with open visitation in the adult ICU has improved from 10.4% of hospitals surveyed in 2008-2009, the change has been very slow. The authors recommend further study with hospitals that have the most flexible open policies to understand and identify successful methods for implementing and sustaining best practice.See Article, pp 221-225Delayed or poor cardiopulmonary resuscitation (CPR) in children may cause adverse outcomes such as neurological sequelae and death. Staff working in less acute care areas have expressed discomfort with initiating and performing CPR because of limited exposure to code events.Wise and colleagues developed a “First-Five” simulation-based training program to improve early response of bedside personnel during a code. After 3 phases of program improvement, they found thatThe authors state that First Five programs are better than mock codes because of the focus on the individual during initial resuscitation rather than on system issues. They recommend that hospitals commit to the education and training of all nurses to improve pediatric code outcomes.See Article, pp 233-236

Ethical Reasoning and Moral Distress in Social Care Among Long-Term Care Staff

There are studies on the normative ethical frameworks used by long-term care staff and studies proposing how staff should reason, but few studies explore how staff actually reason. This study reports on the ethical reasoning process and experiences of moral distress of long-term care staff in the provision of social care. Seven interdisciplinary focus groups were conducted with twenty front-line staff. Staff typically did not have difficulty determining the ethical decision and/or action; however, they frequently experience moral distress. To manage these experiences of moral distress in making ethical decisions, staff 1) comply with being told what to do out of fear of consequences, 2) defer decisions to family, 3) "have a meeting," 4) socialization into and acceptance of workplace culture. Findings suggest that to better understand how and why staff make ethical decisions and improve quality and ethical care, we must explore the interaction between front-line practice and organizational and public policy.

Improvement of Physical and Occupational Therapy Referral Process to Reduce Unskilled Consults

Purpose: Baseline data collected for 9 months showed that physical (PT) and occupational therapy (OT) services were consulted 14.5% of the time for unskilled therapy needs. The goal of this performance improvement project was to identify whether acute care physical and occupational therapists can reduce unskilled consults using a multidisciplinary education intervention. Methods: Therapists were trained on how to define and use each of 4 categories of unskilled consults. An interdisciplinary focus group was formed to gain feedback from providers with regard to the culture of mobility, the role of PT and OT, skilled versus unskilled consults, and strategies to reduce these unskilled consults. After discussion, the focus group determined that the primary strategy to reduce unskilled consults is to incorporate mobility and activities of daily living (ADL) discussion for each patient into interdisciplinary rounds (IDR). Results: Data show that PT and OT services collectively were consulted for unskilled therapy needs 3.05% of the time, compared with baseline data of 14.5%, which is a clinically meaningful decrease. Conclusion: Results provide preliminary evidence that an interdisciplinary approach using IDR can assist with reducing unskilled consults. Establishing a focus group can assist the initiatives through education on what defines an unskilled consult, collaboration, and improved communication regarding patient mobility and ADL performance while hospitalized.

The Medical Treatment Planning and Decisions Act 2016: what is the role for allied health professionals?

Advance care planning is increasingly common practice in contemporary health care for individuals living with a chronic condition. Currently, limited research has been conducted into how newly adopted legislation in Victoria, Australia, facilitates advance care planning. The purpose of this study was to explore the uptake of the Medical Treatment Planning and Decisions Act 2016 in the primary care setting. The study also aimed to explore barriers that allied health professionals encounter when practicing advance care planning with patients. Four interdisciplinary focus groups and two in-depth interviews with participants were conducted and thematically analysed using an interpretivist inquiry paradigm. Analysis revealed two key themes: promoting client wellbeing and scope of practice. The data suggest that advance care planning by allied health professionals in the primary care setting is limited. Focussing on enhancing clients' wellbeing was more important than the development of advanced care directives. Attempting to promote the wellbeing of patients may foster hesitation to commence advance care planning in primary care. This study demonstrated that knowledge of the fundamental legislative changes are evident among allied health professionals which provides a foundation for successful development of advance care planning post implementation of the new Act.