From: Exploring patient-reported barriers to advance care planning in family practice
Theme | Illustrative Quotes | |
---|---|---|
Across all three questions | I’m too young/too healthy for ACP | “Did not see this as necessary, it’s a bit soon. I am only 80!” “I feel that I am too young for making those types of decisions” “not a priority as a healthy person” “I am not at that point in my life. If I was diagnosed with a terminal disease, then I would talk with him” |
Topic is too emotional | “it’s a little frightening to talk about dying” “sad emotional topic” “causing emotional pain to family” “Scares me; it is very negative and would depress me” | |
ACP is the MD’s responsibility: | “If a doctor wanted to talk to me about the end of life, it would not be hard for me to do”. “He would have to suggest the discussion; MD should bring it up” “I would not want my family making medical decisions at the end of my life” | |
Relating only to discussions with Family Physicians | Fear of negative impact on relationship with MD | I may be influenced to sway my thoughts”. “Not knowing if his beliefs and values are the same as mine” “I am not sure that my doctor and I totally agree on treatments” “I don’t want to be unduly influenced by him” |
Not enough time in appointments | “do not allow for an in depth conversation about something that is not happening now or may not ever happen. Appointments are too short”. “Doctor is always too busy. I feel I will impose on his time to talk about this when he has other patients waiting”. “Family doctors are busy people and I would not consider it appropriate to ‘visit’ and discuss a broad topic like end of life” | |
Relating only to discussions with family members | Concern about family dynamics | “I don’t want arguments arising” “I don’t trust them very much to leave this kind of decision to them” |
Relating only to general questions about ACP discussions with anyone | It’s not a priority | “[I’m]too preoccupied” “Though about it but just haven’t acted on it basically” |
I don’t know enough about ACP | “Did not know about advance care planning; I think my family will know what to do”. |