Construction of advance care planning communication protocol for patients in comprehensive intensive care unit

PENG Ruijie; LIU Shufan; JIAN Xumei; DENG Renli; YANG Yan; LI Changxiu

doi:10.16460/j.issn2097-6569.2025.13.001

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Journal of Nursing ›› 2025, Vol. 32 ›› Issue (13) : 1-7. DOI: 10.16460/j.issn2097-6569.2025.13.001

Construction of advance care planning communication protocol for patients in comprehensive intensive care unit

PENG Ruijie^1,2, LIU Shufan^1,2, JIAN Xumei^1,2, DENG Renli^1,2, YANG Yan^1,2, LI Changxiu^1,2

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Abstract

Objective To develop a patient- and family-centered care (PFCC)-based advance care planning (ACP) communication protocol for patients in comprehensive intensive care unit (ICU), and to provide reference for its implementation in critical care clinical practice. Methods From January to May 2024, a protocol framework was constructed through systematic literature review, and the initial protocol was drafted by semi-structured interviews with ICU patients and family members. Two rounds of Delphi expert consultations were performed to finalize the protocol. Results Seventeen articles were collected through systematic literature screening. Based on qualitative interviews with 12 patients and 12 family members (three themes and eight subthemes from interviews with patients, and three themes and nine subthemes from interviews with family members) and core components of PFCC, the preliminary protocol was developed. Authority coefficients of the two rounds of consultations with 15 experts were 0.85 and 0.87, and coefficients of Kendall's concordance 0.189 and 0.232 (both P<0.01), respectively. The final protocol comprised five first-level entries (developing communication strategies, sharing information, participating in communication, reviewing ACP plans, and evaluating communication effectiveness), 10 secondary-level and 30 third-level entries. Conclusion The PFCC-based ACP communication protocol for ICU patients constructed through literature review, qualitative interviews, and expert consultations is reliable and scientific, and combines theoretical depth with clinical applicability. It innovatively integrates PFCC model into ACP communication protocol for ICU patients, systematically operationalizing its four core components—dignity and respect, information sharing, participation, and collaboration—into operational communication processes.

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patient- and family-centered care model / intensive care unit / advance care planning / Delphi method / scheme construction

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PENG Ruijie, LIU Shufan, JIAN Xumei, DENG Renli, YANG Yan, LI Changxiu. Construction of advance care planning communication protocol for patients in comprehensive intensive care unit[J]. Journal of Nursing. 2025, 32(13): 1-7 https://doi.org/10.16460/j.issn2097-6569.2025.13.001

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