Academic Journal
Understanding and optimizing advance care planning implementation for terminally ill older adults: a mixed-methods Meta Analysis of subjective experiences and implementation barriers.
| Τίτλος: | Understanding and optimizing advance care planning implementation for terminally ill older adults: a mixed-methods Meta Analysis of subjective experiences and implementation barriers. |
|---|---|
| Συγγραφείς: | Yue W; School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China. Electronic address: wenyuyue46@outlook.com., Xu J; School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China. Electronic address: 2791765873@qq.com., Ma X; School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China. Electronic address: 1115414667@qq.com. |
| Πηγή: | Geriatric nursing (New York, N.Y.) [Geriatr Nurs] 2026 Jul; Vol. 71, pp. 104094. Date of Electronic Publication: 2026 May 19. |
| Τύπος έκδοσης: | Journal Article; Meta-Analysis |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Mosby-Yearbook Country of Publication: United States NLM ID: 8309633 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1528-3984 (Electronic) Linking ISSN: 01974572 NLM ISO Abbreviation: Geriatr Nurs Subsets: MEDLINE |
| Imprint Name(s): | Publication: St Louis Mo : Mosby-Yearbook Original Publication: [New York : American Journal of Nursing Co. |
| Ιατρικοί όροι (MeSH): | Terminally Ill*/psychology , Advance Care Planning* , Terminal Care*, Humans ; Aged ; Decision Making ; Quality of Life ; Qualitative Research |
| Περίληψη: | Background: Despite widespread recognition of advance care planning (ACP) benefits, evidence regarding its implementation effectiveness for terminally ill older adults remains inconsistent across healthcare settings and cultural contexts. Methods: Following Joanna Briggs Institute methodology and PRISMA guidelines, this review using a systematic approach synthesized 23 studies (15 RCTs, 8 qualitative) published 2005-2024. Quantitative outcomes were meta-analyzed using Review Manager 5.4; qualitative findings underwent meta-aggregation to identify synthesized themes. Results: ACP interventions significantly reduced decision conflict, anxiety, and depression while improving end-of-life decision-making rates and preference concordance, though overall quality of life remained unchanged. Three qualitative themes emerged: knowledge-behavior gap, emotional complexity, and multi-factorial decisions, revealing persistent implementation barriers including systemic healthcare constraints and cultural considerations. Conclusions: Effective ACP implementation requires repositioning it as ongoing patient-paced communication embedded within interdisciplinary care structures, supported by robust continuity mechanisms and cultural adaptations to bridge knowledge-behavior gaps in routine practice. (Copyright © 2026 Elsevier Inc. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. |
| Contributed Indexing: | Keywords: Advance care planning; End-of-life care; Geriatric nursing; Mixed-methods Meta Analysis; Quality of life |
| Entry Date(s): | Date Created: 20260519 Date Completed: 20260716 Latest Revision: 20260716 |
| Update Code: | 20260717 |
| DOI: | 10.1016/j.gerinurse.2026.104094 |
| PMID: | 42155326 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1528-3984 |
|---|---|
| DOI: | 10.1016/j.gerinurse.2026.104094 |