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Multi-Site Study of Provider Self-Efficacy and Beliefs in Explaining Judgments About Need and Responsibility for Advance Care Planning.

Authors
  • Baughman, Kristin R1
  • Ludwick, Ruth1, 2
  • Jarjoura, David3
  • Yeager, Mia1
  • Kropp, Denise1
  • 1 Department of Family and Community Medicine, 6969Northeast Ohio Medical University, Rootstown, OH, USA.
  • 2 4229Kent State University, OH, USA.
  • 3 Consultant, Marshall, NC, USA.
Type
Published Article
Journal
The American journal of hospice & palliative care
Publication Date
Nov 01, 2021
Volume
38
Issue
11
Pages
1276–1281
Identifiers
DOI: 10.1177/1049909120979977
PMID: 33291962
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

We examined the impact of advance care planning (ACP) self-efficacy and beliefs in explaining skilled nursing facility (SNF) provider judgments about resident need and provider responsibility for initiating ACP conversations. This observational multi-site study of 348 registered nurses, licensed practical nurses, and social workers within 29 SNFs used an anonymous survey in which providers judged vignettes with assigned situational features of a typical SNF resident. Mixed modeling was used to analyze the vignette responses. Providers who had more negative beliefs about ACP were less likely to judge residents in need of ACP and less likely to feel responsible for ensuring ACP took place. Self-efficacy did not have a significant impact on judgments of need, but did significantly increase judgments of responsibility for ensuring ACP conversations. Providers with the highest levels of ACP self-efficacy were most likely to feel responsible for ensuring ACP conversations. In an exploratory analysis, these relationships remained the same whether responding to high or low risk residents (i.e., based on risk of hospitalization, type of diagnosis, functional status, and rate of declining health). Both negative beliefs about ACP and self-efficacy in one's ability to conduct ACP discussions were associated with professional judgments regarding ACP. The findings illustrate the importance of addressing negative beliefs about ACP and increasing provider ACP self-efficacy through education and policies that empower nurses and social workers.

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