Are completed ReSPECT plans facilitating person-centred care? An evaluation of completed plans in UK general practice.

Autor:	Huxley CJ; Warwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, United Kingdom., Eli K; Warwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, United Kingdom., Hawkes CA; Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8AW, United Kingdom., Griffiths F; Warwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, United Kingdom., Underwood M; Warwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, United Kingdom., Perkins GD; Warwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, United Kingdom., Blanchard H; Forrest Medical Centre, 6 Prior Deram Walk, Coventry CV4 8FT, United Kingdom., Harlock J; Warwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, United Kingdom., Walsh J; Warwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, United Kingdom., Slowther AM; Warwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, United Kingdom.
Jazyk:	angličtina
Zdroj:	Resuscitation plus [Resusc Plus] 2024 Sep 21; Vol. 20, pp. 100780. Date of Electronic Publication: 2024 Sep 21 (Print Publication: 2024).
DOI:	10.1016/j.resplu.2024.100780
Abstrakt:	Background: The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) includes agreed clinical recommendations for a person's care in a future emergency which have been informed by discussion of the person's preferences. Previous evaluation of ReSPECT plans in acute NHS hospitals found inconsistencies in recording patient's preferences and involvement in the plan, and infrequent justification for recommendations. Aim: To explore to what extent ReSPECT recommendations reflect individual preferences, as documented in the plan. Methods: ReSPECT plans of adults were collected from 11 General Practices in England. We adapted an evaluation tool used previously to analyse ReSPECT plans in acute settings. Free text sections for individual values/preferences and clinical recommendations were examined for clarity, consistency and congruency between them. Results: We retrieved 141 ReSPECT plans. Patients or those close to the patient were recorded as being consulted in most plans (94%). Individual preferences were completed in 57% of plans. Clinical recommendations reflected individual preferences by directly referencing the person and their preferences (31%), by being consistent with the documented preferences (30%), or by using the same wording as the preferences (6%). Conclusion: While many clinical recommendations reflect individual preferences, the preferences themselves are only recorded in just over half of ReSPECT plans. This is problematic, because the recording of individual preferences facilitates person-centred care, both directly by informing recommendations and indirectly when used to guide decision-making in situations not anticipated in the plan. Future training for clinicians should emphasize the need to document the personal values section of the plan. Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: GDP is a Vice President and a member of the ReSPECT subcommittee of the Resuscitation Council UK, a volunteer Director for the European Resuscitation Council and co-chair for the International Liaison Committee on Resuscitation, Editor for Resuscitation and Resuscitation Plus. GDP is supported by the National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) West Midlands. AS, FG, JH, CAH, GDP and MU have participated in other research projects funded by NIHR. CAH was involved in the development of the ReSPECT process and a member of the Resuscitation Council UK ReSPECT Research and Evaluation working group. MU is a co-investigator on grants funded by the Australian 10.13039/501100000925NHMRC and Norwegian MRC. He is a director and shareholder of Clinvivo Ltd that provides electronic data collection for health services research. He is a co-investigator on two current and one completed NIHR funded studies that have, or have had, additional support from 10.13039/100008894Stryker Ltd. AS joined the ReSPECT Stakeholder Group convened by Resuscitation Council UK in March 2024. (© 2024 The Author(s).)
Databáze:	MEDLINE
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