Evidence map›Paper›PMID 42458423›Full record

Observational studyBMC health services research2026

Healthcare professionals' experiences of advance care planning conversations with frail older adults admitted to acute geriatric hospital units: a nested qualitative study.

Karin Berg Hermansen, Trygve Johannes Lereim Saevareid, Reidar Pedersen, Rigmor Einang Alnes, Linn Brøderud, Maria Romøren, May Helen Midtbust

Registry-linked trialAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05681585 (Implementing Advanced Care Planning in the Routine Care for Acutely Admitted Patients in Geriatric Units), which is not on this map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing 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.

NCT05681585 narecruitingnot on this map

Implementing Advanced Care Planning in the Routine Care for Acutely Admitted Patients in Geriatric Units: a Cluster Randomised Controlled Trial

TypeinterventionalSponsorUniversity of OsloRan2023 to 2026Enrolled2,000ConditionsAdvance Care PlanningArmsImplementation support program
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Box 1517, Aalesund, 6025, Norway. karin.hermansen@ntnu.no.ORCID http://orcid.org/0009-0001-4927-2926
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.
Rigmor Einang AlnesDepartment of Health Sciences, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Box 1517, Aalesund, 6025, Norway.
Linn BrøderudCentre 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, 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

backgroundAdvance care planning can support frail older adults, their next of kin, and healthcare professionals by clarifying patients' values and preferences and improving communication toward the end of life. Despite these benefits, advance care planning remains underutilized, particularly among frail older adults with complex needs. Limited research has explored healthcare professionals' experiences with initiating it in acute geriatric settings. As part of a broader research project focused on implementing advance care planning for older adults admitted to acute geriatric hospital units, this study aimed to explore healthcare professionals' experiences with initiating these conversations.

methodsA qualitative sub-study, nested within a cluster randomized controlled trial, was conducted with implementation teams and other healthcare professionals from the six geriatric units in the intervention arm. They had recently started engaging in advance care planning with frail, acutely ill older patients and their next of kin. Data were collected through four focus groups and four dyadic interviews, involving a total of 24 participants. The data was analysed by using reflexive thematic analysis.

resultsFour themes developed as perceived benefits: (1) Amplifies the patients' voice, (2) Improves communication with next of kin, (3) Influences treatment decisions and may avoid overtreatment (4) Contributes to meaningful work. Two themes developed as perceived challenges: (1) Uncertainty regarding the ACP documentation, (2) ACP conversations require dedicated time and focus.

conclusionThis study revealed that advance care planning conversations in acute geriatric hospital units can amplify patients' voices and promote their participation in decision-making. Discussions about existential topics appear beneficial and rewarding for patients, next of kin and healthcare professionals, both for in-moment and future decisions. Time constraints may have led to missed opportunities to initiate ACP conversations with patients before the end of life, while documentation issues may have limited their impact on continuity of care.

trial registrationhttps://ClinicalTrials.gov Identifier NCT05681585. Registered 03.01.23.

Indexed as

Advance Care PlanningAttitude of Health PersonnelCommunicationFrail ElderlyHealth PersonnelAgedAged, 80 and overFemaleFocus GroupsHumansInterviews as TopicMaleMiddle AgedQualitative ResearchRandomized Controlled Trials as TopicAdvance care planningClinical interventionCommunicationHealth personnelOlder patientsQualitative

Identifiers

PMID42458423
PMCPMC13659965

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Registered trials

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.