Evidence map›Paper›PMID 40148938›Full record

Trial reportBMC health services research2025

Raising awareness and preparation for what may come: next of kin experiences of advance care planning with frail, home-dwelling older adults in geriatric units.

Karin Berg Hermansen, Rigmor Einang Alnes, Trygve Johannes Lereim Saevareid, Reidar Pedersen, Siri Faerden Westbye, Maria Romøren, May Helen Midtbust

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Trial
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.

Karin Berg HermansenDepartment of Health Sciences, Aalesund, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Box 1517, Aalesund, 6025, Norway. karin.hermansen@ntnu.no.
Rigmor Einang AlnesDepartment of Health Sciences, Aalesund, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Box 1517, Aalesund, 6025, Norway.
Trygve Johannes Lereim SaevareidCentre for Medical Ethics, Institute of Health and Society, University of Oslo, Box 1130 Blindern, Oslo, 0318, Norway.
Reidar PedersenCentre for Medical Ethics, Institute of Health and Society, University of Oslo, Box 1130 Blindern, Oslo, 0318, Norway.
Siri Faerden WestbyeCentre for Medical Ethics, Institute of Health and Society, University of Oslo, Box 1130 Blindern, Oslo, 0318, Norway.
Maria RomørenCentre for Medical Ethics, Institute of Health and Society, University of Oslo, Box 1130 Blindern, Oslo, 0318, Norway.
May Helen MidtbustDepartment of Health Sciences, Aalesund, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Box 1517, Aalesund, 6025, Norway.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcutely ill and frail older adults and their next of kin are often poorly involved in planning of decisions regarding treatment and care during the final phase of life. Although advance care planning is a well-documented tool to strengthen patient autonomy and involve next of kin, it remains underused in hospital settings. We present a qualitative sub-study embedded in a cluster-randomized controlled trial, whose purpose was to implement advance care planning in Norwegian geriatric units. Frail, home dwelling older adults acutely admitted to geriatric hospital units were invited to participate in advance care planning together with their next of kin. The aim of this study was to explore next of kin experiences of advance care planning.

methodsThe study has a qualitative design, based on individual semi-structured interviews with 13 next of kin. A purposive sampling was used to select next of kin who had recently participated in advance care planning from five geriatric units in the intervention arm. The analysis was conducted using reflexive thematic analysis by Braun and Clarke.

resultsFour themes were developed from the analysis; (1) Being informed and involved through open communication; (2) Getting prepared for what's to come; (3) The importance of the next of kin role in providing support and facilitation; (4) The need for documentation and collaboration across service levels.

conclusionAdvance care planning appears to provide a sense of security among next of kin by addressing their information needs regarding the patient's prognosis, encouraging discussions on possible courses of action, and clarifying the patient's end-of-life preferences. Next of kin played a crucial role in supporting the patient's autonomy, and they considered the hospital stay as an ideal time for advance care planning. Increased awareness of their role as next of kin seems to enhance agreement and trust when confronting challenging situations and existential questions.

trial registrationClinicalTrials.gov Identifier NTCT05681585. Registered 03.01.23.

Indexed as

Advance Care PlanningFamilyFrail ElderlyAgedAged, 80 and overFemaleHumansInterviews as TopicMaleNorwayQualitative ResearchAdvance care planningClinical ethicsDecision-makingNext of kinOlder patientsQualitative methodsRelational autonomy

Identifiers

PMID40148938
PMCPMC11951624

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Registered trials

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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.