Rapid Fire Best of the Best Oral Clinical Oncology Society of Australia Annual Scientific Meeting 2023

What do Australian oncology health professionals know and practice regarding advance care planning?  (#295)

Helena Rodi 1 2 , Linda Nolte 1 , Nicole Kiss 3
  1. North Eastern Melbourne Integrated Cancer Services, Heidelberg, VIC, Australia
  2. School of Exercise & Nutrition Sciences, Faculty of Health, Deakin University, Melbourne, Victoria, Australia
  3. Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia

Aim: This study aimed to (i) examine the knowledge, skills, experiences, perspectives and applications in practice of advance care planning (ACP) by Australian oncology health professionals and (ii) to describe the barriers and facilitators to implementing ACP in oncology settings. Knowing and providing the treatment and care that a person with cancer would want is an integral part of cancer care. The goal of ACP is to align the care the person receives with their preferences for care.  

  

Methods: A national, cross-sectional survey of Australian oncology health professionals was undertaken between November and December 2019. The 69-item purpose designed survey was distributed via key stakeholder organisations and advertising on social media. 

  

Results: The 263 participants represented nurses (50%), allied health (24%), medical (21%) and other (5%) oncology health professionals. Overall, 49-54% of participants reported having good or very good knowledge of ACP topics. With regard to assisting patients with advance care directive completion or appointing substitute decision-makers, 58% and 53% respectively, reported feeling neutral, unskilled or very unskilled.  Only 25% of oncology health professionals discussed ACP with most patients receiving treatment with curative intent however, 80% of health professionals agreed or strongly agreed that they should facilitate ACP. Oncology health professionals who had participated in ACP training had significantly more knowledge, felt more skilled, raised more ACP conversations, and had a more positive perceptions of ACP compared with those who did not. Common barriers to ACP included lack of clinician time (40%), lack of ACP expertise (37%) and lack of role clarity (33%). Facilitators to ACP included more education (97%) and clearly defined roles (96%).  

  

Conclusion: While perceptions of ACP are positive amongst oncology health professionals, knowledge, skills and application in practice are limited. Clearly defined roles and regular ACP training programs are recommended to improve implementation.