Shih Yi-An, Wang Cheng, Ali Ali, Huang Xia, Lu Qian
Inner Mongolia Medical University, Hohhot, China.
School of Nursing, Peking University, Beijing, China.
J Adv Nurs. 2025 Feb;81(2):1082-1094. doi: 10.1111/jan.16413. Epub 2024 Sep 6.
This study aims to explore the practice of advance care planning (ACP) among Chinese oncology nurses and identify challenges influencing care provision.
A sequential explanatory mixed-method design was employed, comprising a quantitative phase to assess communication practices, followed by a qualitative phase to explore the challenges faced in ACP.
The study employed convenience sampling, including 532 oncology nurses from seven hospitals in northern China. Quantitative data were collected through a cross-sectional survey and the ACP communication index from December 2021 to January 2022. The qualitative phase consisted of 19 interviews conducted between May and July 2022, which were thematically analysed to elucidate the challenges in ACP practices.
Quantitative findings revealed a low frequency of ACP communication among Chinese oncology nurses. Qualitative analysis identified four themes: lack of optimal timing, passive engagement of patients or families, reluctance of healthcare professionals and unsupported policies.
The study concluded that identified challenges compromise the effectiveness of ACP practices among Chinese oncology nurses. Inadequate communication, limited interdisciplinary collaboration and policy gaps contribute to nonstandardised ACP processes.
IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The findings underscore the need for targeted interventions to enhance nurses' communication skills, foster interdisciplinary collaboration and provide policy support. Such interventions are pivotal to optimising end-of-life care in oncology settings and facilitating the integration of ACP into routine nursing practices.
This study adhered to the Mixed Methods Article Reporting Standards.
No contributions from patients or the public were involved in this study.
本研究旨在探讨中国肿瘤护理人员的预立医疗照护计划（ACP）实践情况，并确定影响照护提供的挑战因素。
采用序列解释性混合方法设计，包括一个定量阶段以评估沟通实践，随后是一个定性阶段以探讨ACP中面临的挑战。
本研究采用便利抽样，纳入了中国北方七家医院的532名肿瘤护理人员。2021年12月至2022年1月期间，通过横断面调查和ACP沟通指数收集定量数据。定性阶段包括2022年5月至7月进行的19次访谈，对访谈内容进行主题分析以阐明ACP实践中的挑战。
定量研究结果显示，中国肿瘤护理人员的ACP沟通频率较低。定性分析确定了四个主题：缺乏最佳时机、患者或家属的被动参与、医护人员的不情愿以及政策支持不足。
该研究得出结论，已识别的挑战因素损害了中国肿瘤护理人员ACP实践的有效性。沟通不足、跨学科协作有限和政策差距导致了ACP流程的不规范。
对专业和/或患者照护的启示：研究结果强调了有针对性干预措施的必要性，以提高护士的沟通技能、促进跨学科协作并提供政策支持。此类干预措施对于优化肿瘤患者的临终照护以及促进将ACP纳入常规护理实践至关重要。
本研究遵循混合方法文章报告标准。
本研究未涉及患者或公众的贡献。
