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Advance care planning (ACP) is an essential component of quality palliative care that requires expert communication skills. Nurses are often the health care provider patients and families rely on when exploring their values and preferences and making treatment decisions. Therefore, communication and ACP was one of the 3 areas of practice addressed during the Palliative Nursing Summit. This article summarizes patient outcomes and nursing actions recommended by summit participants related to communication and ACP. Areas addressed included education, clinical care, research, and policy/regulation. Recommended patient outcomes included the honoring of patient/family preferences and the inclusion of ACP discussions during routine care and across the life span. Recommended nursing actions included the following: (1) nursing education (both undergraduates and practicing nurses) and competencies related to communication and ACP be developed and implemented; (2) primary palliative care, including communication and ACP, be included in the practice standards of all nursing specialties; (3) health care systems support conversations about ACP and related documentation; (4) research be conducted related to the implementation of patient/family preferences and related health care utilization; and (5) regulation and reimbursement be crafted to support nursing practice related to ACP and related conversations at the nurses' full level of expertise. [ABSTRACT FROM AUTHOR]

Effective communication between family members and clinicians is one of the most important factors in end-of-life care, yet little is known about the extent of such communication in Korea. The purpose of this review was to describe the state of the science in family-clinician communication about end-of-life care in Korea, including the timing of communication, family members' communication needs, and perceived communication quality. The family-physician communication about do-not-resuscitate decision typically occurred near the patient's death. Receiving sufficient information about patient carewas one of the top priorities of family members at the end of life, yet such needs were not met. Physicians and nurses reported they lack communication skills to provide information about patients' prognosis and end-of-life treatment options effectively. While empirical data are limited, our review suggests that family-clinician communication at the end of life in Korea is inadequate. This review provides an insight about the ways clinicians communicate with family members at the end of life in Korea, whichmay be helpful to determine components of communication that need to be improved. [ABSTRACT FROM AUTHOR]

Objectives: To examine feasibility, acceptability and preliminary effects of an advance care planning (ACP) intervention, SPIRIT-HF, in LVAD patients and their surrogates. Background: LVADs may improve HF symptoms but they are not curative. Thus, ACP is needed to prepare patients and surrogates for end-of-life (EOL) decision-making. Methods: Bridge to transplant and destination therapy LVAD patient-surrogate dyads were randomized to either SPIRIT-HF or usual care. Percentages of eligible dyads who were enrolled and completed the study determined feasibility. Analysis of interviews with SPIRIT dyads determined acceptability. Group comparisons of dyad congruence, patient's decisional conflict, and surrogate's decision-making confidence determined preliminary effects. Results: Of 38 eligible dyads, 29 (76%) were enrolled, randomized, and completed the study. The 14 intervention dyads characterized SPIRIT-HF as beneficial. All dyads demonstrated improvement in outcomes. However, SPIRIT-HF dyads tended toward greater congruence on patient EOL treatment goals. Conclusions: SPIRIT-HF is feasible and acceptable. Results will inform future trials. [ABSTRACT FROM AUTHOR]

Purpose: This study was done to identify effects of a life-esteemed education applied logotherapy on life respect, meaning of life, and depression on older elementary school students. Methods: A nonequivalent control group and non-synchronized design was conducted with a convenience sample of 142 students. The program named 'My Precious Life'. consisted of one session per week for five weeks. Students were assigned to the experimental group (n=70) or the control group (72). Data were analyzed using descriptive statistics, Chi-square, Fisher's exact test, t-test, and repeated measured ANOVA with the SPSS/PC 18.0 program. Results: Meaning of life and life respect increased significantly and depression decreased significantly for participants in the experimental group. Conclusion: The results of the study indicate that life-esteemed education applied logotherapy is effective in improving meaning of life and life respect and in decreasing depression in elementary school students. It can also be used to prevent existential distress and to intervene as a motif for having hope in life. [ABSTRACT FROM AUTHOR]

BACKGROUND:: Although many healthcare providers and researchers consider it necessary to assist patients with end-stage chronic illnesses to plan for the end of life, they tend to avoid discussing end-of-life issues with patients before major surgery. Consequently, surgical patients and their families generally have insufficient knowledge to make plans in case of life-threatening complications.OBJECTIVE:: The objective of this study was to evaluate short-term effects of Patient-Centered Advance Care Planning (PC-ACP).DESIGN AND SUBJECTS:: Thirty-two dyads of patients undergoing cardiac surgery and their surrogates were randomly assigned to receive either the PC-ACP intervention (PC-ACP) or usual care.MEASURES:: Measures studied were patient–surrogate congruence regarding goals for future medical care, patient and surrogate knowledge of advance care planning and anxiety, and patient decisional conflict. Congruence and anxiety were measured before and after the intervention. Decisional conflict and knowledge of advance care planning were measured after the intervention.RESULTS:: Compared with the control group, PC-ACP significantly improved patient–surrogate congruence (Δ = 1.27, P < 0.01) and reduced patients’ decisional conflict (Δ = −0.77, P < 0.05). Anxiety change (pre/post) did not differ between treatment and control groups. No difference in knowledge of advance care planning was found between the 2 groups.CONCLUSIONS:: The PC-ACP can be an effective approach to advance care planning. Its specificity and relevance to patients’ actual medical conditions (as exemplified by its plans for potential complications related to cardiac surgery) can lead to greater patient–surrogate congruence without increasing decisional conflict and anxiety. [ABSTRACT FROM AUTHOR]