A new model of advance care planning: observations from people with HIV

Arch Intern Med. 1999 Jan 11;159(1):86-92. doi: 10.1001/archinte.159.1.86.

Abstract

Background: Although theoretical concepts from ethics and law have been applied, there is no conceptual model of advance care planning rooted in the perspective of individuals engaged in it.

Objective: To develop a conceptual model of advance care planning by examining the perspectives of individuals engaged in it.

Methods: In this qualitative research, we studied 140 individuals with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome who were engaged in advance care planning. Respondents' experience with and opinions about advance care planning were noted in interviews that were audiotaped, transcribed, and analyzed.

Results: The primary goal of advance care planning was to prepare for death, which entailed facing death, achieving a sense of control, and strengthening relationships.

Conclusions: We have developed a conceptual model of advance care planning rooted in the perspectives of individuals engaged in it. The model has implications for theory, research, and practice regarding end-of-life care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acquired Immunodeficiency Syndrome / psychology*
  • Acquired Immunodeficiency Syndrome / therapy*
  • Adult
  • Advance Care Planning*
  • Advance Directives*
  • Attitude to Death*
  • Cohort Studies
  • Female
  • HIV Infections / psychology
  • HIV Infections / therapy
  • Humans
  • Male
  • Middle Aged
  • Models, Psychological*
  • Ontario
  • Organizational Policy
  • Patient Care Planning*
  • Qualitative Research
  • Quality of Health Care
  • Random Allocation
  • Research