open access

Vol 18, No 1 (2024)
Research paper
Published online: 2023-07-10
Get Citation

Lessons learned from self-efficacy of healthcare professionals for advance care planning

Vilma Adriana Tripodoro123, María Stella Di Gennaro24, Julia Fila25, Verónica Inés Veloso23, Celeste Quiroga26, Cristina Lasmarías Martínez78
·
Palliat Med Pract 2024;18(1):15-22.
Affiliations
  1. ATLANTES Global Observatory of Palliative Care, University of Navarra, Pamplona, Spain
  2. Instituto Pallium Latinoamérica, Buenos Aires, Argentina
  3. Institute of Medical Research A Lanari, University of Buenos Aires, Argentina
  4. Clínica Reina Fabiola, Córdoba, Argentina
  5. National University of La Plata, Buenos Aires, Argentina
  6. Hospital Cosme Argerich, Buenos Aires, Argentina
  7. Instituto Catalán de Oncología, Barcelona, Spain
  8. Asociacion Espanola de Planificacion Compartida de la Atencion (AEPCA), Barcelona, Spain

open access

Vol 18, No 1 (2024)
Research paper
Published online: 2023-07-10

Abstract

Background: Advance care planning (ACP) is a reflective, deliberative, and structured process based on dialogue and free agreement between the person concerned and healthcare professionals. Argentina has no national ACP program or systematic approach for patients diagnosed with advanced chronic disease. Healthcare providers who treat these patients highlight some main obstacles in initiating the ACP process. Perceived self-efficacy is one of the main predictors of success in learning processes and promotes the acquisition of new behaviours and positive results in implementing ACP. The aim was to sensitise professionals and explore their self-efficacy for ACP before specific training.

Participants and methods: This exploratory, prospective, descriptive study used the self-efficacy ACP-SEs scale already validated in Argentina. Surveyed were 236 healthcare professionals (n 125 physicians/n 111 non-physicians) before specific training courses (2019–2021).

Results: Participants’ experience, training needs, and practices. Most respondents were females (43 years old). Non-physicians (n 111) were 40 nurses, 32 psychologists, 16 social workers, 15 physiotherapists, and 8 other health backgrounds. Over 50% had 5–20 years of professional and primary care experience. When comparing professions, half of the physicians increased by up to 5.23 points higher on the self-efficacy scale than non-physicians. Most participants had no personal advance directives and neither helped a relative nor a patient sign a document. Half of the participants had previously undergone training. Half of the professionals who had done ACP significantly increased their value on the scale by up to 7.5 points more than those who did not. Differences between physicians and non-physicians revealed areas of improvement involving communication skills, roles and tasks, and legal issues.

Conclusions: Healthcare providers’ skills improve with experience and require training to increase self-- efficacy. The following findings should encourage tailor-made training programs in the future. One of the goals of this study was to spark discussions before specific training courses and develop appropriate teaching methods based on perceived self-efficacy in Argentina.

Abstract

Background: Advance care planning (ACP) is a reflective, deliberative, and structured process based on dialogue and free agreement between the person concerned and healthcare professionals. Argentina has no national ACP program or systematic approach for patients diagnosed with advanced chronic disease. Healthcare providers who treat these patients highlight some main obstacles in initiating the ACP process. Perceived self-efficacy is one of the main predictors of success in learning processes and promotes the acquisition of new behaviours and positive results in implementing ACP. The aim was to sensitise professionals and explore their self-efficacy for ACP before specific training.

Participants and methods: This exploratory, prospective, descriptive study used the self-efficacy ACP-SEs scale already validated in Argentina. Surveyed were 236 healthcare professionals (n 125 physicians/n 111 non-physicians) before specific training courses (2019–2021).

Results: Participants’ experience, training needs, and practices. Most respondents were females (43 years old). Non-physicians (n 111) were 40 nurses, 32 psychologists, 16 social workers, 15 physiotherapists, and 8 other health backgrounds. Over 50% had 5–20 years of professional and primary care experience. When comparing professions, half of the physicians increased by up to 5.23 points higher on the self-efficacy scale than non-physicians. Most participants had no personal advance directives and neither helped a relative nor a patient sign a document. Half of the participants had previously undergone training. Half of the professionals who had done ACP significantly increased their value on the scale by up to 7.5 points more than those who did not. Differences between physicians and non-physicians revealed areas of improvement involving communication skills, roles and tasks, and legal issues.

Conclusions: Healthcare providers’ skills improve with experience and require training to increase self-- efficacy. The following findings should encourage tailor-made training programs in the future. One of the goals of this study was to spark discussions before specific training courses and develop appropriate teaching methods based on perceived self-efficacy in Argentina.

Get Citation

Keywords

palliative care, shared care planning, health care education, self-efficacy, advance care planning

Supp./Additional Files (1)
Self-efficacy in Advance Care Planning Scale ACP-SEs Ar (Argentina)
Download
52KB
About this article
Title

Lessons learned from self-efficacy of healthcare professionals for advance care planning

Journal

Palliative Medicine in Practice

Issue

Vol 18, No 1 (2024)

Article type

Research paper

Pages

15-22

Published online

2023-07-10

Page views

336

Article views/downloads

235

DOI

10.5603/PMPI.a2023.0024

Bibliographic record

Palliat Med Pract 2024;18(1):15-22.

Keywords

palliative care
shared care planning
health care education
self-efficacy
advance care planning

Authors

Vilma Adriana Tripodoro
María Stella Di Gennaro
Julia Fila
Verónica Inés Veloso
Celeste Quiroga
Cristina Lasmarías Martínez

References (24)
  1. Rietjens JAC, Sudore RL, Connolly M, et al. European Association for Palliative Care. Definition and recommendations for advance care planning: an international consensus supported by the European Association for Palliative Care. Lancet Oncol. 2017; 18(9): e543–e551.
  2. Lasmarías C, Júdez J, Pérez de Lucas N, Fernández J. Claves en la planificación compartida de la atención. Del diálogo al documento. Monografía SECPAL sobre.
  3. Lasmarías C, Subirana-Casacuberta M, Mancho N, et al. Spanish cross-cultural adaptation and psychometric properties of the advance care planning self-efficacy: a cross-sectional study. J Palliat Med. 2021; 24(12): 1807–1815.
  4. Minto F, Strickland K. Anticipating emotion: a qualitative study of advance care planning in the community setting. Int J Palliat Nurs. 2011; 17(6): 278–284.
  5. Granero-Moya N, Frías-Osuna A, Barrio-Cantalejo IM, et al. [Primary care nurses' difficulties in advance care planning processes: A qualitative study]. Aten Primaria. 2016; 48(10): 649–656.
  6. Simon J, Porterfield P, Bouchal SR, et al. 'Not yet' and 'Just ask': barriers and facilitators to advance care planning – a qualitative descriptive study of the perspectives of seriously ill, older patients and their families. BMJ Support Palliat Care. 2015; 5(1): 54–62.
  7. Aradilla-Herrero A, Tomás-Sabado J, Gómez-Benito J. Death attitudes and emotional intelligence in nursing students. Omega (Westport). 2012; 66(1): 39–55.
  8. De Vleminck A, Houttekier D, Pardon K, et al. Barriers and facilitators for general practitioners to engage in advance care planning: a systematic review. Scand J Prim Health Care. 2013; 31(4): 215–226.
  9. De Vleminck A, Pardon K, Beernaert K, et al. Barriers to advance care planning in cancer, heart failure and dementia patients: a focus group study on general practitioners' views and experiences. PLoS One. 2014; 9(1): e84905.
  10. Killackey T, Peter E, Maciver J, et al. Advance care planning with chronically ill patients: A relational autonomy approach. Nurs Ethics. 2020; 27(2): 360–371.
  11. Gómez-Vírseda C, de Maeseneer Y, Gastmans C. Relational autonomy in end-of-life care ethics: a contextualized approach to real-life complexities. BMC Med Ethics. 2020; 21(1): 50.
  12. Lasmarías C, Aradilla-Herrero A, Esquinas C, et al. Primary care professionals' self-efficacy surrounding advance care planning and its link to sociodemographics, background and perceptions: a cross-sectional study. Int J Environ Res Public Health. 2021; 18(17).
  13. Barutta J, Vollmann J. Advance directives in Latin America. An ethical analysis with a focus on Argentina. Revista Latinoamericana Bioética. 2013; 13(1): 80–87.
  14. Gracia D. The intellectual basis of bioethics in Southern European countries. Bioethics. 1993; 7(2-3): 97–107.
  15. Ley de derecho del paciente, historia clínica y consentimiento informado. 26.742 May 24, 2012. https://www.boletinoficial.gob.ar/detalleAviso/primera/70105/20120524 (26.05.2023).
  16. Macchi M, Pérez M, Alonso J. Planificación de los cuidados en el final de la vida. Perspectivas de profesionales de oncología y cuidados paliativos. Sexualidad, Salud y Sociedad (Rio de Janeiro). 2020(35): 218–236.
  17. Hjorth NE, Hufthammer KO, Sigurdardottir K, et al. ERANet-LAC CODE project group, Core scientific group. Hospital care for the dying patient with cancer: does an advance care planning invitation influence bereaved relatives' experiences? A two country survey. BMJ Support Palliat Care. 2021 [Epub ahead of print].
  18. Canto y Rodriguez J. Autoeficacia y educación. Educacion y Ciencia. 1998; 2: 45–53.
  19. Baughman KR, Ludwick R, Fischbein R, et al. Development of a scale to assess physician advance care planning self-efficacy. Am J Hosp Palliat Care. 2017; 34(5): 435–441.
  20. Triodoro EV. Autoeficacia de los rofesionales en el roceso de Planificación Comartida de la Atención: Validación de Escala ACP–SES en Argentina. In: Paliat M. Editor. Resúmenes de comunicaciones óster.Triodoro EV. ed. 2023 p : 1–35.
  21. Haidet P, Levine RE, Parmelee DX, et al. Perspective: guidelines for reporting team-based learning activities in the medical and health sciences education literature. Acad Med. 2012; 87(3): 292–299.
  22. Vermorgen M, De Vleminck A, Deliens L, et al. Do physicians discuss end-of-life decisions with family members? A mortality follow-back study. Patient Educ Couns. 2018; 101(8): 1378–1384.
  23. Vandenbogaerde I, Miranda R, De Bleecker JL, et al. Advance care planning in amyotrophic lateral sclerosis (ALS): study protocol for a qualitative longitudinal study with persons with ALS and their family carers. BMJ Open. 2022; 12(5): e060451.
  24. Assessing the development of palliative care worldwide: a set of actionable indicators. World Health Organization; 2021. https://play.google.com/store/books/details?id=23dyEAAAQBAJ (26.05.2023).

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., ul. Świętokrzyska 73 , 80–180 Gdańsk, Poland

phone:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl