Advance Care Planning Support Program for Patients with End-Stage Heart Failure: An Integrative Review

Abstract

Introduction: The purpose of this integrative literature review was to synthesize the conceptual framework or theory, intervention, and outcomes for advance care planning support programs for patients with end-stage heart failure. This review was based on studies extracted from electronic databases, including Scopus, Embase on Ovid, ScienceDirect, PubMed, and Wiley Online Library between 2013 and 2023. Keywords used in searching included “advance care planning” OR “advance care plan program” OR “advance care plan intervention” OR “advance care plan support program” AND “end-stage heart failure patient” OR “advanced heart failure patient” OR “refractory heart failure patient”. Seven full-text articles met the inclusion criteria. The total number of articles was then selected based on the quality assessed in accordance with the Joanna Briggs Institute critical appraisal. Conclusions: The results of this study demonstrated that the conceptual framework used to create such a program can be divided into three frameworks: 1) advance care planning and end-of-life care, 2) Respecting Choices model, and 3) Shared Decision-Making approach. Types of programs can be grouped into two types: 1) the individualized advance care planning program, and 2) the group advance care planning program. Activities utilized in the reviewed advance care programs included: 1) watching videos about advance care planning, 2) engaging in discussing about advance care planning and sharing experiences of health care, 3) attending/joining group activities, 4) recording ACP documentation, and 5) consulting/following-up via telephone calls. The programs lasted between 30 and 60 minutes per time, whereas duration of the whole course of the program lasted from 2 weeks to 24 months or until the patient passed away. The results of the program indicate that advance care planning programs can promote decision-making in end-of-life care.