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Predictors of the Willingness to Promote Advance Care Planning among Nurses in Palliative Care Settings in Yogyakarta, Indonesia

*Ike Wuri Winahyu Sari orcid  -  Faculty of Health, Universitas Jenderal Achmad Yani Yogyakarta, Indonesia
Rizqi Wahyu Hidayati  -  Faculty of Health, Universitas Jenderal Achmad Yani Yogyakarta, Indonesia
Open Access Copyright (c) 2021 Nurse Media Journal of Nursing
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

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Background: While previous studies showed that oncology nurses were highly inclined to promote advance care planning (ACP), there is a limited study focusing on ACP that concerns the willingness to promote ACP among palliative nurses in Indonesia. This issue needs to be investigated to determine the causative factors so that interventions for nurses can be arranged to improve ACP in Indonesia.

Purpose: This study aimed to identify predictors of the willingness to promote ACP among nurses in palliative care settings.

Methods: This study used a descriptive-analytical design with a cross-sectional approach. A total of 150 registered nurses with at least one year of experience were purposively recruited. Data were collected using the Indonesian version of the willingness to promote ACP instrument (I-WPACP) with a possible score range of 24 to 120; the higher the score, the higher the willingness to promote ACP. The descriptive statistic, independent t-test, Pearson correlation test, Spearman rank correlation test, and multiple linear regression test were used to analyze the data.

Results: The willingness to promote ACP showed a mean score of 84.73±9.36. The score indicates a high willingness to promote ACP. The experience of receiving palliative care education became a related factor as well as the most closely related factor to the willingness to promote ACP in the palliative care settings (β=0.184; p=0.028).

Conclusion: The willingness to promote ACP among nurses is high and closely related to their experience of receiving education about palliative care. Education about palliative care and training on ACP needs to be developed so that nurses can discuss ACP with patients and family caregivers.

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Keywords: Advance care planning; end-of-life care; Indonesia; palliative care; palliative nursing

Article Metrics:

  1. A’la, M. Z., Setioputro, B., & Kurniawan, D. E. (2018). Nursing students’ attitudes towards caring for dying patients. Nurse Media Journal of Nursing, 8(1), 25-34.
  2. Brinkman-Stoppelenburg, A., Rietjens, J. A., & van der Heide, A. (2014). The effects of advance care planning on end-of-life care: A systematic review. Palliative Medicine, 28(8), 1000–1025.
  3. Chan, C. W., Chui, Y. Y., Chair, S. Y., Sham, M. M., Lo, R. S., Ng, C. S., Chan, H. Y., & Lai, D. C. (2014). The evaluation of a palliative care programme for people suffering from life-limiting diseases. Journal of Clinical Nursing, 23(1-2), 113–123.
  4. Coffey, A., McCarthy, G., Weathers, E., Friedman, M. I., Gallo, K., Ehrenfeld, M., Chan, S., Li, W. H., Poletti, P., Zanotti, R., Molloy, D. W., McGlade, C., Fitzpatrick, J. J., & Itzhaki, M. (2016). Nurses' knowledge of advance directives and perceived confidence in end-of-life care: a cross-sectional study in five countries. International Journal of Nursing Practice, 22(3), 247–257.
  5. Cohen, A., & Nirenberg, A. (2011). Current practices in advance care planning: Implications for oncology nurses. Clinical Journal of Oncology Nursing, 15(5), 547–553.
  6. Connor, S. R & Bermendo, M. C. S. (2014). Worldwide palliative care. Worldwide Palliative Care Alliance
  7. Dahlan, M. S. (2014). Seri 1: Statistik untuk kedokteran dan kesehatan: deskriptif, bivariat, dan multivariat dilengkapi aplikasi menggunakan SPSS. Edisi 6 [Series 1: Statistics for medical and health: descriptive, bivariate and multivariate with application using SPSS. 6th Ed]. Epidemiologi Indonesia
  8. Dahlan, M.S. (2016). Seri 2: Besar sampel dalam penelitian kedokteran dan kesehatan. Edisi 4 [Series 2: Sample size in medical and health research. 4th Ed]. Epidemiologi Indonesia
  9. Detering, K., Silvester, W., Corke, C., Milnes, S., Fullam, R., Lewis, V., & Renton, J. (2014). Teaching general practitioners and doctors-in-training to discuss advance care planning: evaluation of a brief multimodality education programme. BMJ Supportive & Palliative Care, 4(3), 313–321.
  10. Dixon, J., Matosevic, T., & Knapp, M. (2015). The economic evidence for advance care planning: systematic review of evidence. Palliative Medicine, 29(10), 869–884.
  11. Dzeng, E., Colaianni, A., Roland, M., Chander, G., Smith, T. J., Kelly, M. P., Barclay, S., & Levine, D. (2015). Influence of institutional culture and policies on do-not-resuscitate decision making at the end of life. JAMA Internal Medicine, 175(5), 812–819.
  12. Fan, E., & Rhee, J. J. (2017). A self-reported survey on the confidence levels and motivation of New South Wales practice nurses on conducting advance-care planning (ACP) initiatives in the general-practice setting. Australian Journal of Primary Health, 23(1), 80–86.
  13. Gillan, P. C., Jeong, S., & van der Riet, P. J. (2014). End of life care simulation: A review of the literature. Nurse Education Today, 34(5), 766–774.
  14. Hsieh, L. Y., & Lin, S. Y. (2010). A pilot study on the perspectives of hemodialysis room nurses on promoting advance directives. Hu Li Za Zhi, 57(4), 59-67
  15. Hsieh, C. C., Huang, H. P., Tung, T. H., Chen, I. C., Beaton, R. D., Jane, S. W. (2019). The exploration of the knowledge, attitudes and practice behaviors of advanced care planning and its related predictors among Taiwanese nurses. BMC Palliative Care, 18, 99.
  16. Institute of Medicine. (2015). Dying in America: Improving quality and honoring individual preferences near the end of life. The National Academies Press
  17. Izumi, S. (2017). Advance care planning: The nurse's role. The American Journal of Nursing, 117(6), 56–61.
  18. Ke, L. S., Huang, X., O'Connor, M., & Lee, S. (2015). Nurses' views regarding implementing advance care planning for older people: A systematic review and synthesis of qualitative studies. Journal of Clinical Nursing, 24(15-16), 2057–2073.
  19. Kelley, A. S., & Meier, D. E. (2010). Palliative care: A shifting paradigm. The New England Journal of Medicine, 363(8), 781–782.
  20. Maneesriwongul, W. & Dixon, J. K. (2004). Instrument translation process: A method review. Journal of Advanced Nursing, 48(2), 175-186.
  21. Montagnini, M., Smith, H., & Balistrieri, T. (2012). Assessment of self-perceived end-of-life care competencies of intensive care unit providers. Journal of Palliative Medicine, 15(1), 29–36.
  22. O'Sullivan, R., Murphy, A., O'Caoimh, R., Cornally, N., Svendrovski, A., Daly, B., Fizgerald, C., Twomey, C., McGlade, C., & Molloy, D. W. (2016). Economic (gross cost) analysis of systematically implementing a programme of advance care planning in three Irish nursing homes. BMC Research Notes, 9, 237.
  23. Park, H. Y., Kim, Y. A., Sim, J. A., Lee, J., Ryu, H., Lee, J. L., Maeng, C. H., Kwon, J. H., Kim, Y. J., Nam, E. M., Shim, H. J., Song, E. K., Jung, K. H., Kang, E. J., Kang, J. H., & Yun, Y. H. (2019). Attitudes of the general public, cancer patients, family caregivers, and physicians toward advance care planning: a nationwide survey before the enforcement of the life-sustaining treatment decision-making act. Journal of Pain and Symptom Management, 57(4), 774–782.
  24. Putranto, R., Mudjaddid, E., Shatri, H., Adli, M., & Martina, D. (2017). Development and challenges of palliative care in Indonesia: Role of psychosomatic medicine. BioPsychoSocial Medicine, 11, 29.
  25. Rietjens, J., Sudore, R. L., Connolly, M., van Delden, J. J., Drickamer, M. A., Droger, M., van der Heide, A., Heyland, D. K., Houttekier, D., Janssen, D., Orsi, L., Payne, S., Seymour, J., Jox, R. J., Korfage, I. J., & European Association for Palliative Care. (2017). Definition and recommendations for advance care planning: An international consensus supported by the European Association for Palliative Care. The Lancet. Oncology, 18(9), e543–e551.
  26. Rietze, L., Heale, R., Hill, L., & Roles, S. (2016). Advance care planning in nurse practitioner practice: A cross-sectional descriptive study. Nursing Leadership, 29(3), 106–119.
  27. Robinson, L., Dickinson, C., Rousseau, N., Beyer, F., Clark, A., Hughes, J., Howel, D., & Exley, C. (2012). A systematic review of the effectiveness of advance care planning interventions for people with cognitive impairment and dementia. Age and Ageing, 41(2), 263–269.
  28. Shepherd, J., Waller, A., Sanson-Fisher, R., Clark, K., & Ball, J. (2018). Knowledge of, and participation in, advance care planning: A cross-sectional study of acute and critical care nurses' perceptions. International Journal of Nursing Studies, 86, 74–81.
  29. Silveira, M. J. & Forman, J. (2012). End-of-life care from the perspective of primary care providers. Journal of General Internal Medicine, 27(10), 1287–1293.
  30. Tang, M. Y., Li, X. L., Shi, Z. Y., & Fu, W. J. (2020). Knowledge of and willingness to promote advanced care planning among oncology nurses in southwest China. International Journal of Palliative Nursing, 26(4), 175–182.
  31. World Health Organization (WHO). (2016). Planning and implementing palliative care services: a guide for programme managers. WHO Press.
  32. Yadav, K. N., Gabler, N. B., Cooney, E., Kent, S., Kim, J., Herbst, N., Mante, A., Halpern, S. D., & Courtright, K. R. (2017). Approximately one in three US adults completes any type of advance directive for end-of-life care. Health Affairs (Project Hope), 36(7), 1244–1251.

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Last update: 2024-05-18 10:50:35

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