How can advance care planning support hope in patients with advanced cancer and their families: A qualitative study as part of the international ACTION trial

Hana Kodba-Ceh*, Urska Lunder, ACTION consortium, Francesco Bulli, Glenys Caswell, Johannes J. M. van Delden, Marijke C. Kars, Ida J. Korfage, Guido Miccinesi, Judith A. C. Rietjens, Jane Seymour, Alessandro Toccafondi, Marieke Zwakman, Kristian Pollock

*Corresponding author for this work

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Abstract

Objective Clinicians' fears of taking away patients' hope is one of the barriers to advance care planning (ACP). Research on how ACP supports hope is scarce. We have taken up the challenge to specify ways in which ACP conversations may potentially support hope. Methods In an international qualitative study, we explored ACP experiences of patients with advanced cancer and their personal representatives (PRs) within the cluster-randomised control ACTION trial. Using deductive analysis of data obtained in interviews following the ACP conversations, this substudy reports on a theme of hope. A latent thematic analysis was performed on segments of text relevant to answer the research question. Results Twenty patients with advanced cancer and 17 PRs from Italy, the Netherlands, Slovenia, and the United Kingdom were participating in post-ACP interviews. Three themes reflecting elements that provide grounds for hope were constructed. ACP potentially supports hope by being (I) a meaningful activity that embraces uncertainties and difficulties; (II) an action towards an aware and empowered position; (III) an act of mutual care anchored in commitments. Conclusion Our findings on various potentially hope supporting elements of ACP conversations provide a constructive way of thinking about hope in relation to ACP that could inform practice.

Original languageEnglish
Article numbere13719
Number of pages8
JournalEuropean Journal of Cancer Care
Volume31
Issue number6
DOIs
Publication statusE-pub ahead of print - 27 Sep 2022

Bibliographical note

Funding Information:
This work was supported by the European Union's Seventh Framework Programme FP7/2007‐2013 under grant agreement No 602541. The funding source had no role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. Funding Information

Funding Information:
This publication is based on the ACTION project that is funded by the 7th Framework Programme for Research and Technological Development (FP7) under grant agreement No 602541. We are grateful to all participating patients and relatives, facilitators, health care professionals and others who gave support and advice throughout the project.

Publisher Copyright:
© 2022 The Authors. European Journal of Cancer Care published by John Wiley & Sons Ltd.

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