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Journal article

Keeping all options open: Parents' approaches to advance care planning.

Abstract:

Background

Early engagement in advance care planning (ACP) is seen as fundamental for ensuring the highest standard of care for children and young people with a life-limiting condition (LLC). However, most families have little knowledge or experience of ACP.

Objective

To investigate how parents of children and young people with LLCs approach and experience ACP.

Methods

Open-ended, semi-structured interviews were conducted with parents of 18 children; nine children who were currently receiving palliative care services, and nine children who had received palliative care and died. Verbatim transcripts of audiotaped interviews were analysed following principles of grounded theory while acknowledging the use of deductive strategies, taking account of both the child’s condition, and the timing and nature of decisions made.

Results

Parents reported having discussions and making decisions about the place of care, place of death and the limitation of treatment. Most decisions were made relatively late in the illness and by parents who wished to keep their options open. Parents reported different levels of involvement in a range of decisions; many wished to be involved in decision making but did not always feel able to do so.

Discussion

This study highlights that parents’ approaches to decision making vary by the type of decision required. Their views may change over time, and it is important to allow them to keep their options open. We recommend that clinicians have regular discussions over the course of the illness in an effort to understand parents’ approaches to particular decisions rather than to drive to closure prematurely.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1111/hex.12500

Authors

More by this author
Institution:
University of Oxford
Division:
Medical Sciences Division
Department:
Primary Care; Primary Care Health Sciences
Oxford college:
Green Templeton College
Role:
Author
ORCID:
0000-0002-8223-0349


Publisher:
Wiley
Journal:
Health Expectations More from this journal
Volume:
20
Issue:
4
Pages:
675-684
Publication date:
2016-09-01
Acceptance date:
2016-08-27
DOI:
EISSN:
1369-7625
ISSN:
1369-6513
Pmid:
27670148


Language:
English
Keywords:
Pubs id:
pubs:648209
UUID:
uuid:b0c9b2f6-74b0-4fb5-8d74-3dfd748e42a3
Local pid:
pubs:648209
Source identifiers:
648209
Deposit date:
2018-01-19
ARK identifier:

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