For most, it had taken the form of attendance at local study days about the Mental Capacity Act or local practice development meetings. Table Table11 details the
nurses’ roles. Table 1 Roles of nurses who took part in focus groups The nurses took part in 6 focus group discussions about their experiences of providing end-of-life care and views about ACP. We decided to have six focus groups so that each would involve three or four nurses to ensure that nurses had time to talk in some detail about their experiences and views. Three follow up workshops with nurses who had participated in the discussions focused on collaborative interpretation of the focus group data and identification Inhibitors,research,lifescience,medical Inhibitors,research,lifescience,medical of key themes and developing ideas about educational resources for ACP. An aide memoire was designed and used in the focus group discussions to enable the nurses
to reflect on: • When they had first heard of ‘advance care planning’ • Their knowledge and understanding of ACP • Their views about their contribution and roles in ACP • Their experiences of implementing ACP practice in patient Inhibitors,research,lifescience,medical care • Their perceptions of challenges or barriers to ACP • Their training and education needs The aide memoire was developed in the light of existing literature and following consultation Inhibitors,research,lifescience,medical with the nurses at the recruitment meeting. The focus groups were transcribed with nurses’ permission and
analyzed with the aid of the qualitative data analysis package NVIVO [26]. We used Strauss and Corbin’s [27] constant comparative method to generate categories, patterns and themes from the transcribed textual data relating Inhibitors,research,lifescience,medical to experiences and perceptions. The data were initially analyzed by one research team member. mTOR inhibitor Emerging categories and themes were subsequently verified by the research team at a dedicated project meeting and then discussed with the nurses at the follow up workshops. This acted as a form of respondent validation [28] and also generated new insights into the interpretative emphasis we should place on the findings. We do not claim that we have been able to reach data saturation and recommend that further research takes place to check the transferability of the results presented first here. Results First encounters and understandings of ACP Most of the community nurses had first heard of the term ACP between two and three years prior to the focus group discussions. Nurses identified as sources of information about ACP the new documentation being introduced in practice as a result of the Mental Capacity Act [5], discussions about practice and policy development taking place locally and information related to care planning ‘tools’ such as the Gold Standards Framework.
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