Factors influencing advance care planning among cancer patients: A qualitative study

Purpose

The study aims to explore the factors influencing advance care planning among cancer patients, recognizing the importance of understanding these factors to enhance patient outcomes and ensure that patients' preferences are honored.

Methods

Conducted from May to November 2023, this qualitative descriptive study employed a phenomenological research approach. In-depth face-to-face interviews and observations were utilized to gather insights into the factors influencing participation in advance care planning, guided by a semi-structured interview outline based on social ecosystem theory. Content analysis and thematic analysis were applied to identify and interpret key themes from the data.

Results

A total of 17 cancer patients participated in the interviews. The analysis revealed four main themes. Facilitating factors included optimistic health views and positive attitudes toward advance care planning, which encouraged engagement. Conversely, barriers such as a lack of understanding of advance care planning, misconceptions, and negative attitudes hindered participation. Family dynamics played a significant role; trust in family decisions facilitated discussions, while family pressure created challenges. Economic burdens and cultural taboos surrounding death, along with reliance on healthcare providers, impeded open conversations. These findings highlight the necessity for targeted strategies to enhance patient involvement in advance care planning.

Conclusion

Cancer patients' advance care planning is influenced by positive factors like optimistic health views and supportive family dynamics, as well as obstacles such as misconceptions, cultural taboos, and economic burdens. Targeted interventions are needed to empower patients and better align care with their values.