Journal of Hospice and Palliative Care

Korean Society for Hospice and Palliative Care (한국호스피스완화의료학회)
권호 표지
DOI QR코드

DOI QR Code

The Effects of Advance Care Planning on Decision Conflict and Psychological Distress: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

  • Received : 2021.02.24
  • Accepted : 2021.06.24
  • Published : 2021.09.01
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: Advance care planning (ACP) is widely understood to improve end-of-life care. This systematic review and meta-analysis aimed to examine the effects of ACP interventions on decision conflict and psychological distress. Methods: A search of PubMed, CINAHL, CENTRAL, EMBASE, KISS, KoreaMed, and RISS was conducted in November 2020. The study included randomized controlled trials. Data were pooled using fixed- and random-effects models. Results: Fourteen studies were identified that cumulatively included 1,548 participants. ACP interventions were effective in alleviating decision conflict (d=-0.53; 95% CI: -0.83 to -0.23), depression (d=-1.22; 95% CI: -1.71 to -0.74) and anxiety (d=-0.76; 95% CI: -1.12 to -0.39). Conclusion: ACP interventions have significant positive effects on reducing decision conflict and psychological distress. A high level of bias was shown related to allocation concealment and blinding. The results of this study are expected to be useful for end-of-life care providers to improve the effectiveness of ACP interventions.

Keywords

References

  1. Current Status of Life-Sustaining Treatment System [Internet]. Seoul: National Agency for Management of Life-Sustaining Treatment; 2019. [cited 2020 Dec 27]. Available from: https://www.lst.go.kr./comm/monthlyStatistics.do.
  2. Kim H, Kim K. Palliative cancer care stress and coping among clinical nurses who experience end-of-life care. J Hosp Palliat Nurs 2020;22:115-22. https://doi.org/10.1097/NJH.0000000000000624
  3. Rietjens JAC, Sudore RL, Connolly M, van Delden JJ, Drickamer MA, Droger M, et al. Definition and recommendations for advance care planning: an international consensus supported by the European Association for Palliative Care. Lancet Oncol 2017;18:e543-51. https://doi.org/10.1016/S1470-2045(17)30582-X
  4. Steel AJ, Owen LH. Advance care planning: the who, what, when, where and why. Br J Hosp Med (Lond) 2020;81:1-6. https://doi.org/10.12968/hmed.2019.0396
  5. LeBlanc A, Kenny DA, O'Connor AM, Legare F. Decisional conflict in patients and their physicians: a dyadic approach to shared decision making. Med Decis Making 2009;29:61-8. https://doi.org/10.1177/0272989X08327067
  6. Yamauchi K, Nakao M, Nakashima M. Correlates of regret with treatment decision-making among Japanese women with breast cancer: results of an internet-based cross-sectional survey. BMC Womens Health 2019;19:86. https://doi.org/10.1186/s12905-019-0783-5
  7. Knops AM, Goossens A, Ubbink DT, Legemate DA, Stalpers LJ, Bossuyt PM. Interpreting patient decisional conflict scores: behavior and emotions in decisions about treatment. Med Decis Making 2013;33:78-84. https://doi.org/10.1177/0272989X12453500
  8. Prater LC, Wickizer T, Bower JK, Bose-Brill S. The impact of advance care planning on end-of-life care: Do the type and timing make a difference for patients with advanced cancer referred to hospice? Am J Hosp Palliat Care 2019;36:1089-95. https://doi.org/10.1177/1049909119848987
  9. Raskin J, Vermeersch K, Everaerts S, Bleyenbergh PV, Janssens W. Do-not-resuscitate orders as part of advance care planning in patients with COPD. ERJ Open Res 2018;4:00116-2017.
  10. Mack JW, Weeks JC, Wright AA, Block SD, Prigerson HG. End-of-life discussions, goal attainment, and distress at the end of life: predictors and outcomes of receipt of care consistent with preferences. J Clin Oncol 2010;28:1203-8. https://doi.org/10.1200/JCO.2009.25.4672
  11. You HM, Park EY. Relationships between attitude towards treatment, distress, and decision conflict among cancer patients receiving chemotherapy. Asian Oncol Nurs 2019;19:242-51. https://doi.org/10.5388/aon.2019.19.4.242
  12. Green MJ, Schubart JR, Whitehead MM, Farace E, Lehman E, Levi BH. Advance care planning does not adversely affect hope or anxiety among patients with advanced cancer. J Pain Symptom Manage 2015;49:1088-96. https://doi.org/10.1016/j.jpainsymman.2014.11.293
  13. Lyon ME, Jacobs S, Briggs L, Cheng YI, Wang J. A longitudinal, randomized, controlled trial of advance care planning for teens with cancer: anxiety, depression, quality of life, advance directives, spirituality. J Adolesc Health 2014;54:710-7. https://doi.org/10.1016/j.jadohealth.2013.10.206
  14. Houben CHM, Spruit MA, Groenen MTJ, Wouters EFM, Janssen DJA. Efficacy of advance care planning: a systematic review and metaanalysis. J Am Med Dir Assoc 2014;15:477-89. https://doi.org/10.1016/j.jamda.2014.01.008
  15. Jain A, Corriveau S, Quinn K, Gardhouse A, Vegas DB, You JJ. Video decision aids to assist with advance care planning: a systematic review and meta-analysis. BMJ Open 2015;5:e007491. https://doi.org/10.1136/bmjopen-2014-007491
  16. Robinson L, Dickinson C, Rousseau N, Beyer F, Clark A, Hughes J, et al. A systematic review of the effectiveness of advance care planning interventions for people with cognitive impairment and dementia. Age Ageing 2012;41:263-9. https://doi.org/10.1093/ageing/afr148
  17. White P, Cobb D, Vasilopoulos T, Davies L, Fahy B. End-of-life discussions: Who's doing the talking? J Crit Care 2018;43:70-4. https://doi.org/10.1016/j.jcrc.2017.08.031
  18. Hong M, Kim K. Advance care planning among ethnic/racial minority older adults: prevalence of and factors associated with informal talks, durable power of attorney for health care, and living will. Ethn Health 2020:1-10.
  19. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions. New York: John Wiley & Sons; 2011.
  20. Perkins HS. Controlling death: the false promise of advance directives. Ann Intern Med 2007;147:51-7. https://doi.org/10.7326/0003-4819-147-1-200707030-00008
  21. McMahan RD, Knight SJ, Fried TR, Sudore RL. Advance care planning beyond advance directives: perspectives from patients and surrogates. J Pain Symptom Manage 2013;46:355-65. https://doi.org/10.1016/j.jpainsymman.2012.09.006
  22. Song MK, Ward SE, Fine JP, Hanson LC, Lin FC, Hladik GA, et al. Advance care planning and end-of-life decision making in dialysis: a randomized controlled trial targeting patients and their surrogates. Am J Kidney Dis 2015;66:813-22. https://doi.org/10.1053/j.ajkd.2015.05.018
  23. Sumalinog R, Harrington K, Dosani N, Hwang SW. Advance care planning, palliative care, and end-of-life care interventions for homeless people: A systematic review. Palliat Med 2017;31:109-19. https://doi.org/10.1177/0269216316649334
  24. Yun YH, Kang E, Park S, Koh SJ, Oh HS, Keam B, et al. Efficacy of a decision aid consisting of a video and booklet on advance care planning for advanced cancer patients: randomized controlled trial. J Pain Symptom Manage 2019;58:940-8. https://doi.org/10.1016/j.jpainsymman.2019.07.032
  25. Krones T, Budilivschi A, Karzig I, Otto T, Valeri F, Biller-Andorno N, et al. Advance care planning for the severely ill in the hospital: a randomized trial. BMJ Support Palliat Care 2019;bmjspcare-2017-001489.
  26. Nishikawa Y, Hiroyama N, Fukahori H, Ota E, Mizuno A, Miyashita M, et al. Advance care planning for adults with heart failure. Cochrane Database Syst Rev 2020;2:CD013022.
  27. Chan HY, Ng JS, Chan KS, Ko PS, Leung DY, Chan CW, et al. Effects of a nurse-led post-discharge advance care planning programme for community-dwelling patients nearing the end of life and their family members: A randomised controlled trial. Int J Nurs Stud 2018;87:26-33. https://doi.org/10.1016/j.ijnurstu.2018.07.008
  28. Hilgeman MM, Allen RS, Snow AL, Durkin DW, DeCoster J, Burgio LD. Preserving Identity and Planning for Advance Care (PIPAC): preliminary outcomes from a patient-centered intervention for individuals with mild dementia. Aging Ment Health 2014;18:411-24. https://doi.org/10.1080/13607863.2013.868403
  29. Jang KH, Kang KH, Kim DR, Im HN, Kim KH. A study on the motivation to write signing advance medical directives. JKAIS 2019;20:243-9.
  30. Yu HI, Lee YH. Middle-aged adults' attitudes toward dignified death and advance directives, and knowledge of advance directives. J Korean Clin Nurs Res 2020;26:86-96.