Advance care planning among older adults of Moroccan origin: An interview-based study

Hakki Demirkapu; Redouan Hajji; Brahim Chater; Stéphanie De Maesschalck; Lieve Van den Block; Aline De Vleminck; Dirk Devroey

doi:10.1016/j.pec.2023.107794

Advance care planning among older adults of Moroccan origin: An interview-based study

Patient Educ Couns. 2023 Aug:113:107794. doi: 10.1016/j.pec.2023.107794. Epub 2023 May 13.

Authors

Hakki Demirkapu¹, Redouan Hajji², Brahim Chater², Stéphanie De Maesschalck³, Lieve Van den Block⁴, Aline De Vleminck⁴, Dirk Devroey⁵

Affiliations

¹ Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium. Electronic address: hakki.demirkapu@vub.be.
² Academic Center for General Practice KU Leuven, Leuven, Belgium.
³ Department of Public Health and Primary Health Care, Ghent University, Ghent, Belgium.
⁴ End-of-Life Care Research Group, Vrije Universiteit Brussel, Brussels, and Ghent University, Ghent, Belgium.
⁵ Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium.

PMID: 37196404
DOI: 10.1016/j.pec.2023.107794

Abstract

Objective: To explore advance care planning (ACP)-related knowledge, experience, views, facilitators and barriers among older Moroccan adults in Belgium.

Method: General practitioners (GPs) recruited participants for semi-structured interviews. Data were analysed using the constant comparative method.

Results: The 25 interviewees (average age, 74 years) lacked ACP knowledge and had not discussed it with healthcare professionals. After a brief explanation, most interviewees did not find ACP useful. After more explanation with a specific example, they had fewer religious objections and were more willing to have discussions with their GPs and/or relatives. ACP barriers were a lack of knowledge, current good health, potential harm of talking about death, trust in one's children to make care decisions and fear of worrying one's children. Facilitators were GPs' information provision, children's involvement in ACP discussions and the desire to not depend on children.

Conclusion: Many older Moroccan adults lacked familiarity, but were willing to discuss ACP after receiving understandable concrete information. GPs should facilitate ACP discussions for these patients, ideally with adult children involved, with consideration of barriers, individual preferences and generally low educational levels.

Practice implications: GPs should provide comprehensible ACP information with case examples and consider potential barriers and facilitators in this group.

Trial registration: ClinicalTrials.gov NCT04335214.

Keywords: Advance care planning; Elderly; End-of-life care; Ethnic minorities; General practice; Qualitative study.

MeSH terms

Advance Care Planning*
Aged
Belgium
General Practitioners*
Humans
Patients
Qualitative Research
Trust

Associated data

ClinicalTrials.gov/NCT04335214