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Contrasting Approaches in Advance Care Planning in Dementia as Perceived by General Practitioners
Jenny Theodora van der Steen, Jingyuan Xu, Willemijn Tros, Jeanet W. Blom. Innovation in Aging, 2025-12-01
Topic: Risk, prevention and care in population studies
Abstract Various approaches to advance care planning are in use and generally acceptable also for persons with dementia and their care partners. Two contrasting approaches involve a highly scripted, predominantly medical approach to decide on specific treatments in advance versus a more flexible psychosocial, coping-based approach that comprises global care goal setting. We aim to assess for whom and when either approach is preferred from the perspective of general practitioners. General practitioners in the Netherlands participated in the CONT-END randomized controlled trial and we interviewed six practitioners trained in the medical approach and four in the psychosocial approach. We explained the other approach during the interview. Twelve other general practitioners were interviewed after viewing video vignettes of the two approaches shown in random order. With inductive qualitative content analyses, we identified four attributes distinguishing situations in which either approach is preferred: understanding, trust, readiness and momentum. For the medical approach, understanding, trust, and readiness on the part of person and care partner were prerequisites for the right momentum. This may be achieved in a follow-up conversation, but such conversations may also be triggered by urgent medical reasons. In contrast, the psychosocial approach would help understand the person, foster trust and create readiness also in a first conversation early in the course of the disease. Without a clear trigger, momentum would need to be created. We will visualize the contrasting attributes and discuss implications for practice of advance care planning with persons with dementia and their care partners in primary care settings.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
van der Steen, J. T., Xu, J., Tros, W., & Blom, J. W. (2025). Contrasting Approaches in Advance Care Planning in Dementia as Perceived by General Practitioners. Innovation in Aging. https://doi.org/10.1093/geroni/igaf122.2219
Vancouver
van der Steen JT, Xu J, Tros W, Blom JW. Contrasting Approaches in Advance Care Planning in Dementia as Perceived by General Practitioners. Innovation in Aging. 2025. doi:10.1093/geroni/igaf122.2219.
BibTeX
@article{vandersteen2025-644d01cf,
author = {van der Steen, Jenny Theodora and Xu, Jingyuan and Tros, Willemijn and Blom, Jeanet W.},
title = {{Contrasting Approaches in Advance Care Planning in Dementia as Perceived by General Practitioners}},
journal = {Innovation in Aging},
year = {2025},
doi = {10.1093/geroni/igaf122.2219},
url = {https://doi.org/10.1093/geroni/igaf122.2219}
}
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Key findings
- Two contrasting approaches involve a highly scripted, predominantly medical approach to decide on specific treatments in advance versus a more flexible psychosocial, coping-based approach that comprises global care goal setting.
Why it matters
This qualitative study interviewed general practitioners about when a scripted medical approach versus a flexible psychosocial approach to advance care planning is preferred for people with dementia. It is about care planning approaches, not treating, curing or preventing Alzheimer's disease.
Study details
- Study designrandomized controlled trial
- Evidence strengthHigh
How this study scored 44/100
Published in a peer-reviewed journal, and it is a randomised controlled trial. Scored zero for sample size, effect reported and studied in people because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Innovation in Aging) |
| Journal's citation record | 0 / 4 | Innovation in Aging: journal h-index 48 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomised controlled trial |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 1 / 2 | Randomised (as stated in the record) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 0 / 6 | Cited 0.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Jeanet W. Blom: h-index 33 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Leiden University Medical Center: institution h-index 930 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Total | 44 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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