AbstractsMedical & Health Science

The aim of advance care planning (ACP) is to allow patients to take an active part in decision-making, increase the quality of care and minimize the risk of providing treatment that is either futile or not wanted. While it is well recognized that an ACP discussion is an important part of palliative care, there is still a need to explore how it can become part of routine practice, ensuring a timely and person-centred discussion. The purpose of the study was to explore the experience of patients newly diagnosed with advanced lung cancer and their family members of engaging in a discussion about ACP facilitated by palliative care nurses. The study design was qualitative with a purposive sample, employing semi-structured interviews. The facilitation of the ACP discussion was added to an already established palliative support care service for newly diagnosed lung cancer patients in an outpatient clinic provided by two palliative care nurses. A framework for the ACP discussion was developed and an ACP booklet was translated and adapted. The ACP discussion took place in the second session with the support service and was followed by a research interview within two weeks. Interviews were conducted with seven patients receiving the support service. Family members attended five of these interviews. Special focus was on the experience of the booklet, the timing of the discussion and the role of the palliative care nurse in initiating and leading the ACP discussion. Reflective field notes were written after each supportive care session and the research interviews. Interviews were transcribed verbatim and analysed using thematic analysis. Field notes were analysed with the aim of adding secondary data. The findings indicated that opening the ACP discussion early in the care of the patient is acceptable and helpful even though uncomfortable. There seemed to be a tension for the patients between wanting to protect and to prepare their family for their death. The ACP discussion was a process and aided by the booklet. Even though, the patients did not write in the booklet it prompted a discussion and supported the nurse in initiating and having the discussion. This study highlights that an ACP discussion, offered to patients newly diagnosed with lung cancer, may be acceptable and appropriate when structured as a part of a palliative care service. Palliative care nurses can be in a good position to facilitate the discussion in outpatient clinics. The framework, employed in this study, and the booklet were found helpful in opening the discussion. Markmið umræðu um áætlun um meðferðarmarkmið er að gefa sjúklingum tækifæri til að taka virkan þátt í ákvarðanatöku, bæta gæði umönnunar og draga úr því að meðferð, sem er gagnslaus eða ekki óskað eftir, sé veitt. Þessi umræða er mikilvægur hluti af líknarmeðferð en rannsóknir skortir á því hvernig hægt er að gera hana að eðlilegum hluta umönnunar sjúklinga sem fari fram tímanlega og sé miðuð að einstaklingnum. Tilgangur rannsóknarinnar var að kanna reynslu sjúklinga sem eru nýgreindir með…