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Understanding and addressing challenges for advance care planning in the COVID-19 pandemic: An analysis of the UK CovPall survey data from specialist palliative care services

Bradshaw, Andy; Dunleavy, Lesley; Walshe, Catherine; Preston, Nancy; Cripps, Rachel L.; Hocaoglu, Mevhibe; Bajwah, Sabrina; Maddocks, Matthew; Oluyase, Adejoke O.; Sleeman, Katherine; Higginson, Irene J.; Fraser, Lorna; Murtagh, Fliss

Authors

Andy Bradshaw

Lesley Dunleavy

Catherine Walshe

Nancy Preston

Rachel L. Cripps

Mevhibe Hocaoglu

Sabrina Bajwah

Matthew Maddocks

Adejoke O. Oluyase

Katherine Sleeman

Irene J. Higginson

Lorna Fraser



Abstract

Background: Specialist palliative care services play an important role in conducting advance care planning during COVID-19. Little is known about the challenges to advance care planning in this context, or the changes services made to adapt. Aim: Describe the challenges that UK specialist palliative care services experienced regarding advance care planning during COVID-19 and changes made to support timely conversations. Design: Online survey of UK palliative/hospice services’ response to COVID-19. Closed-ended responses are reported descriptively. Open-ended responses were analysed using a thematic Framework approach using the Social Ecological Model to understand challenges. Respondents: Two hundred and seventy-seven services. Results: More direct advance care planning was provided by 38% of services, and 59% provided more support to others. Some challenges to advance care planning pre-dated the pandemic, whilst others were specific to/exacerbated by COVID-19. Challenges are demonstrated through six themes: complex decision making in the face of a new infectious disease; maintaining a personalised approach; COVID-19-specific communication difficulties; workload and pressure; sharing information; and national context of fear and uncertainty. Two themes demonstrate changes made to support: adapting local processes and adapting local structures. Conclusions: Professionals and healthcare providers need to ensure advance care planning is individualised by tailoring it to the values, priorities, and ethnic/cultural/religious context of each person. Policymakers need to consider how high-quality advance care planning can be resourced as a part of standard healthcare ahead of future pandemic waves. In facilitating this, we provide questions to consider at each level of the Social Ecological Model.

Citation

Bradshaw, A., Dunleavy, L., Walshe, C., Preston, N., Cripps, R. L., Hocaoglu, M., …Murtagh, F. (2021). Understanding and addressing challenges for advance care planning in the COVID-19 pandemic: An analysis of the UK CovPall survey data from specialist palliative care services. Palliative medicine, 35(7), 1225-1237. https://doi.org/10.1177/02692163211017387

Journal Article Type Article
Acceptance Date Apr 19, 2021
Online Publication Date May 26, 2021
Publication Date Jul 1, 2021
Deposit Date Aug 31, 2021
Publicly Available Date Mar 29, 2024
Journal Palliative Medicine
Print ISSN 0269-2163
Electronic ISSN 1477-030X
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Volume 35
Issue 7
Pages 1225-1237
DOI https://doi.org/10.1177/02692163211017387
Keywords Palliative care; Hospices; Coronavirus; Surveys and questionnaires; Pandemics; Advance care planning
Public URL https://hull-repository.worktribe.com/output/3778845

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