title: [Primary care nurses' difficulties in advance care planning processes: A qualitative study].
abstract: OBJECTIVE
  To know the primary care nurses' difficulties to promote advance care planning process with patients in the end of life.
  
  
  METHODS
  Phenomenological qualitative methodology.
  
  
  METHODS
  Health Management Area North of Jaén.
  
  
  METHODS
  Primary care nurses.
  
  
  METHODS
  Purposive sampling. Fourteen in-depth interviews were conducted until the speeches saturation. Content analysis in four steps: transcription, coding, obtaining results and conclusions verification. Supported whit the software Nvivo 8. Triangulation of results between researchers.
  
  
  RESULTS
  Professionals' difficulties: Lack of knowledge about the topic, lack of communication skills, lack of experience and presence of negative emotions. In the health institution lack of time and interference with other professionals is a barrier. Also the patient's attitude and the family are identified as an obstacle because few people speak about the end of life. Finally, our society prevents open discussion about issues related to death.
  
  
  CONCLUSIONS
  Professional learning about advanced care planning, training in communication skills and emotional education are necessary. Health managers should consider the fact that early interventions for planning health decisions require training, time and continued attention. If a cultural change does not happen, an evasive way to face the end of life will persist.
authors.affiliation: Hospital S. Juan de la Cruz, Úbeda, Jaén, España. Electronic address: nanigranero@gmail.com.
authors.forename: Nani
authors.initials: N
authors.lastname: Granero-Moya
authors.affiliation: Universidad de Jaén, Jaén, España.
authors.forename: Antonio
authors.initials: A
authors.lastname: Frías-Osuna
authors.affiliation: Centro de Salud Almanjáyar, Granada, España.
authors.forename: Inés M
authors.initials: IM
authors.lastname: Barrio-Cantalejo
authors.affiliation: Centro de Salud Murcia Centro-San Juan, Área de Salud VI-Vega Media del Segura, Servicio Murciano de Salud, Murcia, España.
authors.forename: Antonio Jesús
authors.initials: AJ
authors.lastname: Ramos-Morcillo
mesh_terms: D000328:Adult; D032722:Advance Care Planning; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059017:Primary Care Nursing; D036301:Qualitative Research
keywords: Advance care planning; Bioethics; Bioética; Cuidados al final de la vida; End of life care; Enfermeras de atención primaria; Investigación cualitativa; Planificación anticipada de las decisiones; Primary care nurses; Qualitative research