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Sustainable implementation of advance care planning in Asia: An interpretive-systemic framework for national development

Published online by Cambridge University Press:  03 August 2020

Andy Hau Yan Ho Open the ORCID record for Andy Hau Yan Ho [Opens in a new window] ,
Priya Lall Open the ORCID record for Priya Lall [Opens in a new window] ,
Woan Shin Tan Open the ORCID record for Woan Shin Tan [Opens in a new window] ,
Paul Victor Patinadan Open the ORCID record for Paul Victor Patinadan [Opens in a new window] ,
Lok Hang Wong ,
Oindrila Dutta Open the ORCID record for Oindrila Dutta [Opens in a new window] ,
Weng Sun Pang ,
Chan Kee Low  and
Josip Car Open the ORCID record for Josip Car [Opens in a new window]
Andy Hau Yan Ho*
Affiliation:
Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore The Palliative Care Centre for Excellence in Education and Research (PalC), Singapore
Priya Lall
Affiliation:
College of Social Science, University of Lincoln, Lincoln, UK
Woan Shin Tan
Affiliation:
Health Services & Outcomes Research Department, National Healthcare Group, Singapore
Paul Victor Patinadan
Affiliation:
Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore
Lok Hang Wong
Affiliation:
Tan Tock Seng Hospital, Clinical Epidemiology, Singapore
Oindrila Dutta
Affiliation:
Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore
Weng Sun Pang
Affiliation:
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
Chan Kee Low
Affiliation:
Economics Program, School of Social Sciences, Nanyang Technological University, Singapore
Josip Car
Affiliation:
Centre for Population Health Sciences (CePHaS), Nanyang Technological University, Singapore
*
Author for correspondence: Andy Hau Yan Ho, Nanyang Technological University, 48 Nanyang Avenue, SHHKB-04-03, Singapore 639818. E-mail: andyhyho@ntu.edu.sg
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Abstract

Objectives

A qualitative interpretive-systemic focus group study was conducted to examine the developmental and implementational underpinnings of Asia's first national Advance Care Planning (ACP) programme constituted in Singapore.

Methods

63 physicians, nurses, medical social workers, and allied health workers who actively rendered ACP were purposively recruited across seven major public hospitals and specialist centers.

Results

Framework analysis revealed 19 themes, organized into 5 categories including Life and Death Culture, ACP Coordination, ACP Administration, ACP Outcomes, and Sustainability Shift. These categories and themes formed an Interpretive-Systemic Framework of Sustainable ACP, which reflects the socio-cultural, socio-political, and socio-spiritual contexts that influence ACP provision, highlighting the need to adopt a public health strategy for enhancing societal readiness for end-of-life conversations.

Significance of results

The Interpretive-Systemic Framework of Sustainable ACP underscores the importance of health policy, organizational structure, social discourse, and shared meaning in ACP planning and delivery so as to support and empower care decision-making among terminally ill Asian patients and their families facing mortality.

Keywords

Advance care planningAsiaImplementation sciencePolicy makingQualitative research
Type
Original Article
Information
Palliative & Supportive Care , Volume 19 , Issue 1 , February 2021 , pp. 82 - 92
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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