Objective:Chronic kidney disease significantly impacts patient mortality and quality of life. Advance care planning allows patients to receive their preferred treatment when entering the end stage of the disease and reduces anxiety in family members and healthcare professionals. However, it remains less practiced among this patient group, and effective intervention is needed. Thus, this literature review aims to identify advance care planning interventions for chronic kidney disease patients.
Methods:A literature search was conducted using keywords that included chronic kidney disease, advance care planning intervention, advance care directive, and living will in ProQuest, PubMed, Scopus, Cochrane, and Google Scholar. Inclusion criteria: research articles published in peer-reviewed journals or research papers within the last ten years, only articles written in English, original research, and full-text. Articles that were excluded were studies not related to advance care planning intervention, focused on only the health professionals’ training program, and studied only pediatric participants. Data was illustrated using a descriptive and narrative approach.
Results:Of 7,117 citations, 24 articles were included. The successful implementations comprise establishing trust between patient and healthcare staff, adjusting individualized advance care planning, discussing based on the individual’s situation, responses, and perspective, developing culturally appropriate intervention, training healthcare staff regarding advance care planning intervention, inviting family members to discuss, adapting documentation simply to use, initiating discussion by the proper time, place, and introduction, training patients as expert patients, and conducting communication simulation. In contrast, difficulties include inappropriate intervention methods and disagreements between patients and their proxies. There is a diverse evaluation among previous studies, and few studies have evaluated the concordance of patients’ wishes and their received end-of-life care.
Conclusion:Further studies should apply successful strategies, be aware of difficulties, and evaluate whether patients receive end-of-life care following their preference, which is determined by the advance care planning intervention process.
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