Facilitators and hinders in Advance Care Planning conversations between patients with haematological diseases and healthcare professionals: A Meta-Aggregation.
Background: Patients with haematological diseases face severe complications, long recovery, and poor prognoses, with limited treatment response. Given rapid progression, paying attention to quality-of-life and end-of-life care are essential. Early advance care planning (ACP) conversations cover care preferences, quality of life, palliative and end-of-life decisions.
Aim: To explore the perspectives of healthcare professionals and adult patients with haematological diseases in the hospital setting regarding facilitators or hinders for initiating ACP conversations.
A meta-aggregation was conducted using the Joanna Briggs Institute (JBI) approach. A search of the databases PubMed, EMBASE, PsycINFO and CINAHL was conducted. The search strategy covered terms relating to ACP and haematological diseases. The JBI quality checklist was used. Extracted findings were based on report results and answer the research question. They were categorised by similarity and synthesised. The confidence of the synthesised findings was evaluated using the ConQual approach.
Eight reports on seven studies were included. 30 findings were grouped into ten categories, and synthesised into three synthesised findings. The 3 synthesised findings are: 1. No specific moment and a lack of time for the ACP conversation. 2. Lack of knowledge about the ACP conversation. 3. The ACP conversation must allow for emotions and ensure safety and familiarity. The initial synthesised findings have a moderate ConQual score, while the final finding has a high score.
Conclusion: This study identified hinders and facilitators to initiating ACP conversations for haematological patients. Hinders include disagreement on timing, lack of scheduled time, and limited knowledge. Preparation materials can help. Facilitators include allowing emotions and ensuring safety and familiarity.
Implications: Further research would be recommended implementing ACP for haematological patients, it is necessary to consider the facilitators and hinders that have been identified in this study when formulating implementation strategies. This approach enhances the probability of a successful implementation.