{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T12:16:06Z","timestamp":1783080966138,"version":"3.54.6"},"reference-count":22,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Hosp Palliat Care"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This systematic review synthesizes randomized controlled trial evidence on the effectiveness of nurse-led ACP interventions for patients with advanced cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched PubMed, Embase, CINAHL, Web of Science, and the Cochrane Central Register from inception to January 2026. Eligible studies were randomized controlled trials (RCTs) evaluating nurse-led ACP interventions in adults with advanced or metastatic cancer. Two reviewers independently screened records, extracted data, and assessed risk of bias using the Cochrane Risk of Bias 2 (RoB 2) tool. A narrative synthesis was performed due to clinical and methodological heterogeneity precluding meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Six studies (7 publications; N = 2816) met inclusion criteria, conducted in the United States, South Korea, and six European countries. Nurse-led ACP interventions consistently increased advance directive completion (adjusted odds ratios 2.5-5.3) and end-of-life conversation rates vs usual care. One trial showed facilitated nurse-led ACP outperformed patient-directed approaches in ACP engagement (adjusted difference 0.25; 95% CI 0.10-0.40;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .001). Quality of life outcomes were mixed; most trials showed no significant difference at 3 months, though higher-intensity interventions trended toward greater benefit. Overall risk of bias was low to moderate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Nurse-led ACP interventions are feasible and effective in improving ACP engagement and end-of-life outcomes for patients with advanced cancer. Successful implementation requires standardized training, adequate intervention intensity, and systematic follow-up. Future trials should use validated patient-reported ACP measures and explore optimal timing and delivery methods.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10499091261464945","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T05:03:27Z","timestamp":1782795807000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Nurse-Led Advance Care Planning Interventions for Patients with Advanced Cancer: A Systematic Review"],"prefix":"10.1177","author":[{"given":"Shaomin","family":"Wu","sequence":"first","affiliation":[{"name":"Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuangli","family":"Zhu","sequence":"additional","affiliation":[{"name":"Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun","family":"Li","sequence":"additional","affiliation":[{"name":"Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2525-7238","authenticated-orcid":false,"given":"Lili","family":"Xing","sequence":"additional","affiliation":[{"name":"Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21871"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2016.12.331"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c1345"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/0269216314526272"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1000678"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1198"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.5271"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.158.4.383"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2014.58.6362"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/10499091241276009"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/s1470-2045(17)30582-x"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2021.5185"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2022.0008"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15082310"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1200\/op-25-00046"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2025.105102"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003422"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2023.7002"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1017\/s1478951509000108"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2010.07.004"}],"container-title":["American Journal of Hospice and Palliative Medicine\u00ae"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10499091261464945","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10499091261464945","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10499091261464945","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T11:17:42Z","timestamp":1783077462000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10499091261464945"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,29]]},"references-count":22,"alternative-id":["10.1177\/10499091261464945"],"URL":"https:\/\/doi.org\/10.1177\/10499091261464945","relation":{},"ISSN":["1049-9091","1938-2715"],"issn-type":[{"value":"1049-9091","type":"print"},{"value":"1938-2715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,29]]},"article-number":"10499091261464945"}}