How Do General Practitioners Conceptualise Advance Care Planning in Their Practice? A Qualitative Study.
OBJECTIVE
To explore how GPs conceptualise advance care planning (ACP), based on their experiences with ACP in their practice.


METHODS
Five focus groups were held with 36 GPs. Discussions were analysed using a constant comparative method.


RESULTS
Four overarching themes in the conceptualisations of ACP were discerned: (1) the organisation of professional care required to meet patients' needs, (2) the process of preparing for death and discussing palliative care options, (3) the discussion of care goals and treatment decisions, (4) the completion of advance directives. Within these themes, ACP was both conceptualised in terms of content of ACP and/or in terms of tasks for the GP. A specific task that was mentioned throughout the discussion of the four different themes was (5) the task of actively initiating ACP by the GP versus passively waiting for patients' initiation.


CONCLUSIONS
This study illustrates that GPs have varying conceptualisations of ACP, of which some are more limited to specific aspects of ACP. A shared conceptualisation and agreement on the purpose and goals of ACP is needed to ensure successful implementation, as well as a systematic integration of ACP in routine practice that could lead to a better uptake of all the important elements of ACP.
End-of-Life Care Research group, Ghent University & Vrije Universiteit Brussel (VUB), Brussels, Belgium.
Aline
A
De Vleminck
End-of-Life Care Research group, Ghent University & Vrije Universiteit Brussel (VUB), Brussels, Belgium.
Koen
K
Pardon
End-of-Life Care Research group, Ghent University & Vrije Universiteit Brussel (VUB), Brussels, Belgium.
Kim
K
Beernaert
End-of-Life Care Research group, Ghent University & Vrije Universiteit Brussel (VUB), Brussels, Belgium.
Dirk
D
Houttekier
End-of-Life Care Research group, Ghent University & Vrije Universiteit Brussel (VUB), Brussels, Belgium.|Heymans Institute, Ghent University, Ghent, Belgium.
Robert
R
Vander Stichele
End-of-Life Care Research group, Ghent University & Vrije Universiteit Brussel (VUB), Brussels, Belgium.|Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium.
Luc
L
Deliens
D000328:Adult; D032722:Advance Care Planning / Q000458:organization & administration; D000368:Aged; D005260:Female; D017144:Focus Groups; D058005:General Practitioners / Q000458:organization & administration; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000458:organization & administration; D010817:Physician-Patient Relations; D036301:Qualitative Research