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Nursing home manager's knowledge, attitudes and beliefs about advance care planning for people with dementia in long‐term care settings: a cross‐sectional survey
Esther‐Ruth Beck, Sonja McIlfatrick, Felicity Hasson, Gerry Leavey. Journal of Clinical Nursing, 2017-02-09
Topic: Risk, prevention and care in population studies
Aims and objectives To examine nursing home managers’ knowledge, attitudes, beliefs and current practice regarding advance care planning for people with dementia in long‐term care settings informed by the theory of planned behaviour. Background Internationally, advance care planning is advocated for people with dementia. However, evidence suggests that discussions with people with dementia are rare, particularly in long‐term care settings. Whilst nursing home managers can be considered central to implementation in this setting, there is a dearth of research that has examined their perspective. This study reports on their role with regard to advance care planning and the perceived factors which influence this. Design A cross‐sectional postal survey was carried out as part of a larger scale sequential explanatory mixed‐methods study between January–March 2015. Setting and participants Nursing home managers in a region in the UK ( n = 178). Results A response rate of 66% ( n = 116) was achieved. Nursing home managers demonstrated a lack of knowledge of advance care planning, with negative attitudes underpinned by concerns regarding the capacity and lack of perceived benefits to the person with dementia. Currently, they do not view advance care planning as part of their role, with lack of ownership impacting upon current practice behaviours. Conclusions Whilst nursing home managers recognise the potential benefits of advance care planning, barriers and challenges create a reluctance to facilitate. Targeted training to address the knowledge deficit is required, with the wider components of advance care planning promoted. There is a need for greater role clarification to ensure nurses in long‐term care settings identify with the process in the future. A gap between rhetoric and reality of implementation is evident; therefore, long‐term care settings must critically examine system, organisational and individual factors for failure to implement advance care planning for people with dementia. Relevance to Clinical Practice Increased cognisance of the context in which advance care planning takes place is vital for improved implementation in this context. In addition strong nursing leadership is imperative to facilitate initiation, engagement and re‐evaluation of the process of advance care planning.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Beck, E., McIlfatrick, S., Hasson, F., & Leavey, G. (2017). Nursing home manager's knowledge, attitudes and beliefs about advance care planning for people with dementia in long‐term care settings: a cross‐sectional survey. Journal of Clinical Nursing. https://doi.org/10.1111/jocn.13690
Vancouver
Beck E, McIlfatrick S, Hasson F, Leavey G. Nursing home manager's knowledge, attitudes and beliefs about advance care planning for people with dementia in long‐term care settings: a cross‐sectional survey. Journal of Clinical Nursing. 2017. doi:10.1111/jocn.13690.
BibTeX
@article{beck2017-0427f276,
author = {Beck, Esther‐Ruth and McIlfatrick, Sonja and Hasson, Felicity and Leavey, Gerry},
title = {{Nursing home manager's knowledge, attitudes and beliefs about advance care planning for people with dementia in long‐term care settings: a cross‐sectional survey}},
journal = {Journal of Clinical Nursing},
year = {2017},
doi = {10.1111/jocn.13690},
url = {https://doi.org/10.1111/jocn.13690}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- However, evidence suggests that discussions with people with dementia are rare, particularly in long‐term care settings.
- Results A response rate of 66% ( n = 116) was achieved.
- Nursing home managers demonstrated a lack of knowledge of advance care planning, with negative attitudes underpinned by concerns regarding the capacity and lack of perceived benefits to the person with dementia.
Why it matters
This survey of nursing home managers in the UK found they lacked knowledge of advance care planning and held negative attitudes, with concerns about capacity and perceived lack of benefit to the person with dementia. Managers did not view advance care planning as part of their role, and this lack of ownership affected current practice.
Study details
- Participants178
- Evidence strengthLow
How this study scored 43/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of Clinical Nursing) |
| Journal's citation record | 2 / 4 | Journal of Clinical Nursing: journal h-index 174 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2017 — within 10 year(s) of the newest study here |
| Sample size | 2 / 4 | 178 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 4 / 7 | Cited 66 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 6.0 citations a year over 11 year(s) since 2017 |
| Impact for its field and year | 3 / 6 | Cited 3.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 2 other studies in this library |
| Still being cited | 2 / 4 | Cited 15 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Gerard Leavey: h-index 51 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | University of Ulster: institution h-index 418 (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 | 0 / 2 | Behind a paywall — scores zero |
| Total | 43 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1111/jocn.13690
- Original source →
- Free full text: Ulster University Research Portal (Ulster University) →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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