Evidence map›Paper›PMID 26797091›Full record

ReviewBMC geriatrics2016

A review of the implementation and research strategies of advance care planning in nursing homes.

E Flo, B S Husebo, P Bruusgaard, E Gjerberg, L Thoresen, L Lillemoen, R Pedersen

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in BMC geriatrics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
57citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

57 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Trial
  7. Trial
  8. Trial
  9. Trial
  10. Trial
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Advance Care Planning in German General Practice: A Longitudinal Qualitative Study on Patients' Expectations and Experiences.Health expectations : an international journal of public participation in health care and health policy · 2025
    Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

E FloCentre for Elderly-and Nursing Home Medicine, Department of Global Public Health and Primary Care, University of Bergen, P.O. Box: 7200, Bergen, Norway. Elisabeth.Flo@uib.no.
B S HuseboCentre for Elderly-and Nursing Home Medicine, Department of Global Public Health and Primary Care, University of Bergen, P.O. Box: 7200, Bergen, Norway. Bettina.Husebo@uib.no.
P BruusgaardCentre for Medical Ethics, Institute of Health and Society, University of Oslo, Oslo, Norway. pernillebru@yahoo.no.
E GjerbergCentre for Medical Ethics, Institute of Health and Society, University of Oslo, Oslo, Norway. elisabeth.gjerberg@medisin.uio.no.
L ThoresenCentre for Medical Ethics, Institute of Health and Society, University of Oslo, Oslo, Norway. lisbeth.thoresen@medisin.uio.no.
L LillemoenCentre for Medical Ethics, Institute of Health and Society, University of Oslo, Oslo, Norway. lillian.lillemoen@medisin.uio.no.
R PedersenCentre for Medical Ethics, Institute of Health and Society, University of Oslo, Oslo, Norway. reidar.pedersen@medisin.uio.no.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNursing home (NH) patients have complex health problems, disabilities and needs for Advance Care Planning (ACP). The implementation of ACP in NHs is a neglected research topic, yet it may optimize the intervention efficacy, or provide explanations for low efficacy. This scoping review investigates methods, design and outcomes and the implementation of ACP (i.e., themes and guiding questions, setting, facilitators, implementers, and promoters/barriers).

methodsA systematic search using ACP MESH terms and keywords was conducted in CINAHL, Medline, PsychINFO, Embase and Cochrane libraries. We excluded studies on home-dwelling and hospital patients, including only specific diagnoses and/or chart-based interventions without conversations.

resultsSixteen papers were included. There were large variations in definitions and content of ACP, study design, implementation strategies and outcomes. Often, the ACP intervention or implementation processes were not described in detail. Few studies included patients lacking decision-making capacity, despite the fact that this group is significantly present in most NHs. The chief ACP implementation strategy was education of staff. Among others, ACP improved documentation of and adherence to preferences. Important implementation barriers were non-attending NH physicians, legal challenges and reluctance to participate among personnel and relatives.

conclusionACP intervention studies in NHs are few and heterogeneous. Variation in ACP definitions may be related to cultural and legal differences. This variation, along with sparse information about procedures, makes it difficult to collate and compare research results. Essential implementation considerations relate to the involvement and education of nurses, physicians and leaders.

Indexed as

Mental CompetencyTerminal CareAdvance Care PlanningAgingCommunication BarriersDecision MakingHomes for the AgedHumansNursing Homes

Identifiers

PMID26797091
PMCPMC4722739

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.