Barriers and Facilitators of Advance Care Planning in Patients With Cancer: A Qualitative Study

作者：Yang Yang, Li Jingling, M. Huang, Ting Wang, Kezhou Yang, Bo Deng, Lingling Wu, Ming Liu, Ning Liu · 发表于：Journal of Clinical Nursing · 年份：2025 · DOI：10.1111/jocn.70158 · 被引用次数：3 · 研究领域：Palliative Care and End-of-Life Issues、Complementary and Alternative Medicine Studies、Economic and Financial Impacts of Cancer

BACKGROUND: Advance Care Planning (ACP) has the potential to enhance end-of-life care and improve the allocation of healthcare resources for patients with cancer. However, its successful implementation requires considerable effort to overcome challenges and deliver health benefits. Healthcare providers and patients are key players in ACP, and their perceptions of the process must be understood to address implementation challenges effectively. AIMS AND OBJECTIVES: To identify barriers and facilitators to ACP implementation in Chinese oncology settings, providing a foundation for culturally appropriate healthcare strategies. METHODS: A qualitative study guided by the Consolidated Framework for Implementation Research (CFIR). Semi-structured interviews (n = 30) were conducted between April and August 2022 to synthesise the perspectives of nurses, physicians, patients with cancer and their families who had participated in ACP. Data were analysed using a directed qualitative content analysis approach, and reporting followed the SRQR guidelines. RESULTS: Twenty implementation determinants were identified across four CFIR domains, including 13 barriers and 7 facilitators. Key barriers included limited adaptability of ACP to local cultural and family norms, high complexity of ACP processes, insufficient knowledge and skills among clinicians, unclear team responsibilities, low organisational readiness, limited resources and poor public awareness. Facilitators included strong team cult...