Health care workers lack advance care planning training for chronic kidney disease patients

Health care professionals (HCPs) report lacking materials and training to conduct advance care planning (ACP) among patients with chronic kidney disease (CKD), according to a study published online April 17 in the Scandinavian Journal of Caring Sciences.

Christina Egmose Frandsen, R.N., from Odense University Hospital in Denmark, and colleagues assessed Danish nephrology HCPs' knowledge and attitudes about ACP and the status of current ACP practice in Denmark. HCPs were recruited via email lists and were sent an anonymous, cross-sectional online survey.

Based on responses from 207 participants (nephrologists: 23 percent; physicians: 8 percent; nurses: 62 percent; other HCPs: 7 percent), the researchers found that 27 percent had participated in ACP training. Two-thirds of respondents reported that they lacked access to materials about ACP for patients with CKD and 46 percent said that the conversations were performed ad hoc. Less than half (47 percent) reported that ACP was performed well at their workplace. Reported barriers included time, lack of experience, and lack of procedure. Nurses responded feeling less skilled and comfortable in engaging in ACP, while respondents with >10 years of experience were more likely to feel skilled and comfortable.

"Education and training in ACP with patients with CKD and their families, on both a theoretical and clinical level, is important to ensure comfortability among HCPs and to facilitate involvement in ACP conversations," the authors write.