Deakin University

File(s) under permanent embargo

Does implementation matter if comprehension is lacking? A qualitative investigation into perceptions of advance care planning in people with cancer

journal contribution
posted on 2018-05-11, 00:00 authored by Anna UgaldeAnna Ugalde, Clare O'Callaghan, Clem Byard, Samantha Brean, Jenelle MacKay, Anna Boltong, Sondra Davoren, Deborah Lawson, Phillip Parente, Natasha Michael, Trish LivingstonTrish Livingston
PURPOSE: While advance care planning holds promise, uptake is variable and it is unclear how well people engage with or comprehend advance care planning. The objective of this study was to explore how people with cancer comprehended advance care plans and examine how accurately advance care planning documentation represented patient wishes. METHODS: This study used a qualitative descriptive design. Data collection comprised interviews and an examination of participants' existing advance care planning documentation. Participants included those who had any diagnosis of cancer with an advance care plan recorded: Refusal of Treatment Certificate, Statement of Choices, and/or Enduring Power of Attorney (Medical Treatment) at one cancer treatment centre. RESULTS: Fourteen participants were involved in the study. Twelve participants were female (86%). The mean age was 77 (range: 61-91), and participants had completed their advance care planning documentation between 8 and 72 weeks prior to the interview (mean 33 weeks). Three themes were evident from the data: incomplete advance care planning understanding and confidence, limited congruence for attitude and documentation, advance care planning can enable peace of mind. Complete advance care planning understanding was unusual; most participants demonstrated partial comprehension of their own advance care plan, and some indicated very limited understanding. Participants' attitudes and their written document congruence were limited, but advance care planning was seen as helpful. CONCLUSIONS: This study highlighted advance care planning was not a completely accurate representation of patient wishes. There is opportunity to improve how patients comprehend their own advance care planning documentation.



Supportive care in cancer






3765 - 3771




Berlin, Germany





Publication classification

C1 Refereed article in a scholarly journal

Copyright notice

2018, Springer-Verlag GmbH Germany, part of Springer Nature