AbstractGlobally, populations are ageing, which is increasingly associated with an increase in the global chronic illness burden. This implies longer and more complex illness trajectories and more need for medical decision-making across life and at the end of it. In this context, there has been growing interest in advance care planning which is defined as enabling individuals to define their goals and preferences for future treatment and care, to discuss these with family and healthcare providers, and to record and review these, if appropriate. This process can be undertaken at any time but is widely considered to be an integral part of long-term care.
While advance care planning has been shown to bring numerous clinical and psychosocial benefits to patients and families, implementation in daily nursing home practice still seems to be a challenge. Effectiveness research has therefore been recently recommended to go beyond ‘does it work’ to also evaluate ‘how and under which circumstances’.
The aim of this PhD thesis was threefold : 1) To explore what are preconditions for successful ACP in nursing homes, 2) To develop an intervention programme to improve the implementation of advance care planning in nursing homes in Flanders, and to describe the design of a cluster randomised controlled trial and process evaluation to evaluate its effects and underlying processes of change, 3) To describe the current state of affairs regarding advance care planning on staff level in nursing homes in Flanders.
|Date of Award||17 Dec 2019|
|Supervisor||Lieve Van den Block (Promotor), Chris Gastmans (Promotor), Luc Deliens (Co-promotor), Lara Pivodic (Co-promotor), Judith Rietjens (Jury), Francesca Ingravallo (Jury), Jan De Lepeleire (Jury), Koen Milissen (Jury), Liesbeth De Donder (Jury) & Dirk Devroey (Jury)|
- advance care
- nursing homes