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Nursing home staff members’ knowledge, experience and attitudes regarding advance care planning: a cross-sectional study involving 12 Italian nursing homes

  • Giovanni OttoboniEmail author
  • Rabih Chattat
  • Claudia Camedda
  • Martina Galletti
  • Sonia Macripò
  • Elena Mariani
  • Francesca Ingravallo
Original Article
  • 12 Downloads

Abstract

Background

Advance care planning may be beneficial for nursing home residents, but its implementation is suboptimal in several countries.

Aims

To investigate knowledge of, attitudes towards, and experience with advance care planning of nursing home staff members in Italy.

Methods

Cross-sectional survey involving all healthcare professionals working in 12 Italian nursing homes. Statistical analyses investigated interactions between participants’ characteristics, knowledge, attitudes and frequency of advance care planning discussion with residents.

Results

Of the 185 participants (80.5% female, mean age 43.6 ± 9.2 years), 29.7% reported that they had heard of advance care planning, but their actual knowledge was suboptimal. Participants had positive attitudes towards advance care planning, and most of them clearly recognized its benefits. Apprehension about upsetting the patient or their family, or that patients were not ready for these conversations were the main concerns. Only 16% of respondents discussed advance care planning at least sometimes, usually upon patient/family input. Greater knowledge was significantly correlated with more positive attitudes towards advance care planning. The issues of healthcare professionals’ knowledge and training in advance care planning, and of knowledge and awareness of advance care planning in patients, their families, and the general population were considered either main barriers or facilitators.

Discussion

Nursing home staff members’ concerns towards advance care planning seemed to be related to a misconception about patient and family willingness to discuss it.

Conclusions

A multifaceted strategy including educational and training programmes and the increase of public awareness is needed to implement advance care planning in Italian nursing homes.

Keywords

Advance care planning Older people Caregivers Healthcare professionals Residential care facilities Italy 

Notes

Acknowledgements

The authors would like to thank all the nursing home staff members who participated in this study, and they also thank Ilaria Cerquetti and Veronica Mignani for their valuable help in data collection and management.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Due to the study anonymous data collection, formal consent was not required.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of PsychologyUniversity of BolognaBolognaItaly
  2. 2.Department of Medical and Surgical Sciences, DIMECUniversity of BolognaBolognaItaly
  3. 3.Department of Diagnostic-Clinical Medicine and Public HealthUniversity of Modena and Reggio EmiliaModenaItaly

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