The Medical Treatment Planning and Decisions Act 2016: what is the role for allied health professionals?
Aidan Borthwick A B and Peter Higgs AA School of Psychology and Public Health, Department of Public Health, La Trobe University, Plenty Road, Bundoora, Vic. 3086, Australia.
B Corresponding author. Email: a.borthwick@latrobe.edu.au
Australian Journal of Primary Health 26(5) 383-387 https://doi.org/10.1071/PY19212
Submitted: 1 July 2020 Accepted: 9 September 2020 Published: 25 September 2020
Abstract
Advance care planning is increasingly common practice in contemporary health care for individuals living with a chronic condition. Currently, limited research has been conducted into how newly adopted legislation in Victoria, Australia, facilitates advance care planning. The purpose of this study was to explore the uptake of the Medical Treatment Planning and Decisions Act 2016 in the primary care setting. The study also aimed to explore barriers that allied health professionals encounter when practicing advance care planning with patients. Four interdisciplinary focus groups and two in-depth interviews with participants were conducted and thematically analysed using an interpretivist inquiry paradigm. Analysis revealed two key themes: promoting client wellbeing and scope of practice. The data suggest that advance care planning by allied health professionals in the primary care setting is limited. Focussing on enhancing clients’ wellbeing was more important than the development of advanced care directives. Attempting to promote the wellbeing of patients may foster hesitation to commence advance care planning in primary care. This study demonstrated that knowledge of the fundamental legislative changes are evident among allied health professionals which provides a foundation for successful development of advance care planning post implementation of the new Act.
Keywords: advance care planning, disease management, primary health care.
References
Carr D, Luth EA (2017) Advance care planning: contemporary issues and future directions. Innovation in Aging 1, igx012| Advance care planning: contemporary issues and future directions.Crossref | GoogleScholarGoogle Scholar | 30480109PubMed |
Department of Health and Human Services, State Government of Victoria (2016) Summary: Medical Treatment Planning and Decisions Act 2016. Chisholm Health Ethics Bulletin 22(2), 6–10. Available at http://chisholmhealthethics.org.au/ [Verified 17 September 2020]
Detering KM, Hancock AD, Reade MC, Silvester W (2010) The impact of advance care planning on end of life care in elderly patients: randomised controlled trial. British Medical Journal 340, c1345
| The impact of advance care planning on end of life care in elderly patients: randomised controlled trial.Crossref | GoogleScholarGoogle Scholar | 20332506PubMed |
Garrido MM, Balboni TA, Maciejewski PK, Bao Y, Prigerson HG (2015) Quality of life and cost of care at the end of life: the role of advance directives. Journal of Pain and Symptom Management 49, 828–835.
| Quality of life and cost of care at the end of life: the role of advance directives.Crossref | GoogleScholarGoogle Scholar | 25498855PubMed |
Kitzinger J (1994) The methodology of focus groups: the importance of interaction between research participants. Sociology of Health & Illness 16, 103–121.
| The methodology of focus groups: the importance of interaction between research participants.Crossref | GoogleScholarGoogle Scholar |
Murray SA, Sheikh A, Thomas K (2006) Advance care planning in primary care. British Medical Journal 333, 868–869.
| Advance care planning in primary care.Crossref | GoogleScholarGoogle Scholar | 17068016PubMed |
Patton MQ (2015) ‘Qualitative research & evaluation methods: integrating theory and practice.’ (Sage Publications: London, UK)
Phillippi J, Lauderdale J (2018) A guide to field notes for qualitative research: context and conversation. Qualitative Health Research 28, 381–388.
| A guide to field notes for qualitative research: context and conversation.Crossref | GoogleScholarGoogle Scholar | 29298584PubMed |
Rose M, Welz M (2018) Perhaps quality of life should not be used as a trigger for discussing resuscitation and advance care plans. Emergency Medicine Australasia 30, 578–580.
| Perhaps quality of life should not be used as a trigger for discussing resuscitation and advance care plans.Crossref | GoogleScholarGoogle Scholar | 29609194PubMed |
Smith A (2018) Developments in Australian incapacity legislation. Precedent (Sydney, N.S.W.) 4–8.
Thanh NC (2015) The interconnection between interpretivist paradigm and qualitative methods in education. American Journal of Educational Science 1, 24–27.
Ulin PR, Robinson ET, Tolley EE (2012) ‘Qualitative methods in public health: a field guide for applied research.’ (John Wiley & Sons: Hoboken, NJ, USA)
Willmott L, White B, Stackpoole C, Then SN, Man H, Yu M, Shen W (2017) Guardianship and health decisions in China and Australia: a comparative analysis. Asian Journal of Comparative Law 12, 371–400.
| Guardianship and health decisions in China and Australia: a comparative analysis.Crossref | GoogleScholarGoogle Scholar |
Yap SS, Chen K, Detering K, Fraser SA (2018) Exploring the knowledge, attitudes and needs of advance care planning in older Chinese Australians. Journal of Clinical Nursing 27, 3298–3306.
| Exploring the knowledge, attitudes and needs of advance care planning in older Chinese Australians.Crossref | GoogleScholarGoogle Scholar | 28544056PubMed |
Zwakman M, Jabbarian LJ, Van Delden J, Van Der Heide A, Korfage IJ, Pollock K, Rietjens J, Seymour J, Kars MC (2018) Advance care planning: a systematic review about experiences of patients with a life-threatening or life-limiting illness. Palliative Medicine 32, 1305–1321.
| Advance care planning: a systematic review about experiences of patients with a life-threatening or life-limiting illness.Crossref | GoogleScholarGoogle Scholar | 29956558PubMed |