{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T09:11:38Z","timestamp":1778577098913,"version":"3.51.4"},"reference-count":21,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"unspecified","delay-in-days":131,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Pall Supp Care"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1478951526102508_sec1a\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We aimed to evaluate patient and clinician experiences of advance care planning (ACP) conversations facilitated by an ACP nurse coordinator (ACP-NC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951526102508_sec2b\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used a sequential mixed-methods approach that included a patient survey, patient interviews, and clinician interviews at a family medicine clinic. Patients were invited into the study if they had reached a stable\u00a0point in their ACP decision-making conversations with the ACP-NC or PCP (i.e.\u00a0their goals and preferences were considered settled at the time) and were not imminently dying. Invitations to complete a survey were sent within 2 weeks of patients completing their ACP conversations. Patient interviewees were purposefully selected to vary on key attributes such as age, gender, and number of ACP conversations. An iterative sampling strategy was used for both patient and clinician interviews.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951526102508_sec3c\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ninety-three patients completed the survey, and 10 patients were interviewed. Six clinicians were interviewed. Sixty percent of patient respondents reported being very comfortable\u00a0having ACP conversations. At the time of the survey, 79% had completed or revised their existing advance directive. The professional groups that patients most preferred to engage with, regarding ACP, were their primary care provider (87%), ACP-NC (70%), and palliative care specialist (61%). Patient interviews indicated that participants appreciated being referred to the ACP-NC within the clinic, describing her as a motivator and generous with her time, which facilitated thoughtful discussion of preferences and wishes. Clinician interviews identified limited time as a key barrier to conducting ACP conversations and saw a dedicated ACP-NC as a major benefit to allow patients to spend more time having these important conversations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951526102508_sec4d\">\n                    <jats:title>Significance of results<\/jats:title>\n                    <jats:p>Patients were open to engaging in ACP discussions. Integrating an ACP-NC within primary care teams may represent an acceptable\u00a0and effective approach to promote the early initiation of ACP in primary care settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1478951526102508","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T08:20:15Z","timestamp":1778574015000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Impact of nurse-led advance care planning in a primary care setting"],"prefix":"10.1017","volume":"24","author":[{"given":"Sumathi","family":"Devarajan","sequence":"first","affiliation":[{"name":"Oregon Health & Science University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6159-3909","authenticated-orcid":false,"given":"Rebecca","family":"Rdesinski","sequence":"additional","affiliation":[{"name":"Oregon Health & Science University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shannon","family":"Sweeney","sequence":"additional","affiliation":[{"name":"Oregon Health & Science University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eriko","family":"Onishi","sequence":"additional","affiliation":[{"name":"Oregon Health & Science University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin","family":"Gallivan","sequence":"additional","affiliation":[{"name":"Oregon Health & Science University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harry","family":"Krulewitch","sequence":"additional","affiliation":[{"name":"Oregon Health & Science University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9488-9458","authenticated-orcid":false,"given":"Seiko","family":"Izumi","sequence":"additional","affiliation":[{"name":"Oregon Health & Science University"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"S1478951526102508_ref12","first-page":"e190","article-title":"Barriers to and enablers of advance care planning with patients in primary care: Survey of health care providers","volume":"64","author":"Howard","year":"2018","journal-title":"Canadian Family Physician"},{"key":"S1478951526102508_ref8","article-title":"Medicare program; revisions to payment policies under the physician fee schedule and other revisions to part B for CY 2016","volume":"80","year":"2015","journal-title":"Federal Register"},{"key":"S1478951526102508_ref15","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-019-0411-z"},{"key":"S1478951526102508_ref5","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare-2020-002851"},{"key":"S1478951526102508_ref1","unstructured":"Ariadne Labs. (2025) Patient-Centered Care Starts With a Conversation. What are Your Wishes? What are Your Worries? What matters to you? https:\/\/www.ariadnelabs.org\/serious-illness-care\/patient-centered-serious-illness-care\/ (accessed 31 July 2025)."},{"key":"S1478951526102508_ref2","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-020-01167-0"},{"key":"S1478951526102508_ref9","doi-asserted-by":"publisher","DOI":"10.1177\/1049909118824546"},{"key":"S1478951526102508_ref14","doi-asserted-by":"publisher","DOI":"10.1017\/S1478951523000214"},{"key":"S1478951526102508_ref17","doi-asserted-by":"publisher","DOI":"10.51256\/ANJ032417"},{"key":"S1478951526102508_ref6","doi-asserted-by":"publisher","DOI":"10.3109\/02813432.2013.854590"},{"key":"S1478951526102508_ref18","first-page":"1689","article-title":"Bioethics for clinicians: 6. 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Published by Cambridge University Press.","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e140"}}