Barriers Perceived by Link Nurses in Conducting Advance Care Planning for Cancer Patients

Abstract

Objective: To identify the barriers link nurses perceive in providing ACP to cancer patients. Methods: Semi-constructive interviews were conducted with eight link nurses at a base hospital for cancer treatment, and text mining was used for cluster and correspondence analyses, which has the advantage of ensuring objectivity in qualitative research. Results: The barriers for link nurses are “difficulty in sharing various information about patients,” “difficulty in giving back what they learned in the training and arousing interest,” “difficulty in explaining ACP while continuing chemotherapy,” “difficulty in timing owing to hesitation of bad news from life expectancy announcement,” “difficulty in stepping into each person’s thoughts about terminal care,” “anxiety about not being able to confirm ACP respecting patients’ wishes while crossing facilities,” “difficulty in learning from others’ practice situations,” and “difficulty in learning from others.” We identified the following 13 barriers: “difficulty in entering into each person’s thoughts about the terminal” “anxiety about not being able to confirm ACP that respects the patient’s wishes while crossing facilities” “difficulty in learning from others’ practice situations.” Conclusions: This study suggests for systems to support ACP, practice-based education, and support for link nurses.