Nov 16, 2021
This episode features Dr Diah Martina (Department of Medical
Oncology, Erasmus MC Cancer Institute, University Medical Center
Rotterdam, Rotterdam, The Netherlands).
Asian healthcare professionals hold that patients’ family play a
central role in advance care planning and rarely engage patients in
it. Despite the wide range of studies on advance care planning in
different populations in Asian countries, and despite their
variety of methodologies and conceptualizations of advance care
planning, there has been no systematic synthesis of their
results.
This study demonstrates that although a majority of Asian patients
regarded advance care planning as necessary, more varied results
were produced by studies that examined their actual willingness
to engage in it. Willingness to engage in advance care
planning was affected not only by patients’ knowledge of their
disease and advance care planning, but also by their beliefs: (a)
about its advantages or disadvantages; (b) that its concept
should be in accordance with patients’ faith and their families’ or
physicians’ wishes; and (c) about the presence of barriers to it
(e.g. complexities of future planning, socioeconomic
dependence, and the unreadiness of the healthcare system).
Initial steps toward engaging Asian patients in advance care
planning should include: (a) an exploration of their understanding
of their disease; and (b) the correction of common misperceptions
through education on what advance care planning entails.
Advance care planning for Asian patients needs to accommodate: (a)
patients’ widely differing beliefs on it; (b) their preferences
regarding the way in which values are communicated, that is,
when and by whom; and (c) whether or not it is documented.