학술논문
Consensus definition of advance care planning in dementia: A 33-country Delphi study.
Document Type
Academic Journal
Author
van der Steen JT; Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.; Department of Primary and Community Care, and Radboudumc Alzheimer Center, Radboud university medical center, Nijmegen, The Netherlands.; Nakanishi M; Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.; Department of Psychiatric Nursing, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai-shi Miyagy, Japan.; Van den Block L; VUB-UGent End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium.; Di Giulio P; Department of Public Health Sciences and Pediatrics, Turin University, Turin, Italy.; Gonella S; Direction of Health Professions, City of Health and Science University Hospital of Turin, Turin, Italy.; In der Schmitten J; Institute for General Practice/Family Medicine, Medical Faculty, University of Duisburg-Essen, Essen, Germany.; Sudore RL; Division of Geriatrics, Department of Medicine, University of California [more locations], San Francisco, California, USA.; San Francisco Veterans Affairs Medical Center, San Francisco, California, USA.; Harrison Dening K; Research & Publications, Dementia UK, London, UK.; Faculty of Health & Life Sciences, De Montfort University, Leicester, UK.; Parker D; IMPACCT/School of Nursing and Midwifery, Faculty of Health, University of Technology, Sydney, Australia.; Mimica N; University Psychiatric Hospital Vrapče, School of Medicine, University of Zagreb, Zagreb, Croatia.; Holmerova I; Faculty of Humanities, Centre of Expertise in Longevity and Long-Term Care and Centre of Gerontology, Charles University, Prague, Czech Republic.; Larkin P; Palliative and Supportive Care Service and Institute of Higher Education and Research in Healthcare, UNIL, Université de Lausanne, CHUV, Centre hospitalier universitaire Vaudois, Faculté de biologie et de médecine - FBM Institut universitaire de formation et de recherche en soins - Hôpital Nestlé, Lausanne, Switzerland.; Martins Pereira S; CEGE: Research Center in Management and Economics - Ethics and Sustainability Research Area, Universidade Católica Portuguesa, Católica Porto Business School, Porto, Portugal.; Rietjens JAC; Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.; Department of Design, Organisation and Strategy, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands.; Korfage IJ; Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Source
Publisher: John Wiley & Sons, Ltd Country of Publication: United States NLM ID: 101231978 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1552-5279 (Electronic) Linking ISSN: 15525260 NLM ISO Abbreviation: Alzheimers Dement Subsets: MEDLINE
Subject
Language
English
Abstract
Introduction: Existing advance care planning (ACP) definitional frameworks apply to individuals with decision-making capacity. We aimed to conceptualize ACP for dementia in terms of its definition and issues that deserve particular attention.
Methods: Delphi study with phases: (A) adaptation of a generic ACP framework by a task force of the European Association for Palliative Care (EAPC); (B) four online surveys by 107 experts from 33 countries, September 2021 to June 2022; (C) approval by the EAPC board.
Results: ACP in dementia was defined as a communication process adapted to the person's capacity, which includes, and is continued with, family if available. We identified pragmatic boundaries regarding participation and time (i.e., current or end-of-life care). Three interrelated issues that deserve particular attention were capacity, family, and engagement and communication.
Discussion: A communication and relationship-centered definitional framework of ACP in dementia evolved through international consensus supporting inclusiveness of persons with dementia and their family.
Highlights: This article offers a consensus definitional framework of advance care planning in dementia. The definition covers all stages of capacity and includes family caregivers. Particularly important are (1) capacity, (2) family, (3) engagement, and communication. Fluctuating capacity was visualized in relation to roles and engaging stakeholders.
(© 2023 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)
Methods: Delphi study with phases: (A) adaptation of a generic ACP framework by a task force of the European Association for Palliative Care (EAPC); (B) four online surveys by 107 experts from 33 countries, September 2021 to June 2022; (C) approval by the EAPC board.
Results: ACP in dementia was defined as a communication process adapted to the person's capacity, which includes, and is continued with, family if available. We identified pragmatic boundaries regarding participation and time (i.e., current or end-of-life care). Three interrelated issues that deserve particular attention were capacity, family, and engagement and communication.
Discussion: A communication and relationship-centered definitional framework of ACP in dementia evolved through international consensus supporting inclusiveness of persons with dementia and their family.
Highlights: This article offers a consensus definitional framework of advance care planning in dementia. The definition covers all stages of capacity and includes family caregivers. Particularly important are (1) capacity, (2) family, (3) engagement, and communication. Fluctuating capacity was visualized in relation to roles and engaging stakeholders.
(© 2023 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)