Concept Analysis of Advance Care Planning for Patients with Chronic Diseases

Abstract

Aims: Recent initiatives in advance care planning (ACP) are drawing attention in Japan as well. Patients with chronic diseases are not exceptions to this and demand clinical practice of ACP; however, there is no consensus on this topic. Thus, we performed a concept analysis to obtain a clear definition of ACP for patients with chronic diseases.

Methods: The Walker & Avant’s method of concept analysis was performed on 14 articles.

Results: The following were extracted as attributes of ACP: understanding required for self-decision-making, relationship between people, emotional vacillation, self-decision-making, ease of access to decisions, and continuity and revision. The antecedents to ACP were appropriate timing to think about ACP while living with illness, being noticed by people involved, and inexperience and preparation of healthcare providers. The consequences of ACP were care that meets the patients’ wishes and having an insight for the future.

Conclusions: The ACP for patients with chronic diseases was defined as the timely and cyclical process of drawing out treatment or care goals by adequate communication between healthcare providers and the patients and their families as they experience vacillating emotions.