10100- NQPC-4 ACTIVITIES OF OITA UNIVERSITY NEUROSURGICAL UNIT TO ESTABLISH ACP SUPPORT FRAMEWORK FOR BRAIN TUMOR PATIENTS

Abstract BACKGROUND Advance care planning (ACP) involves thinking ahead about desired medical treatment and care at the end of life and discussing and sharing this information with the medical and care team. Our facility in Oita Prefecture, which performs surgery and induction chemoradiotherapy for malignant brain tumors, has been providing ACP support for brain tumor patients since 2019. We report on our multidisciplinary collaboration activities and evaluation, including creating a brain tumor-specific ACP leaflet in July 2022. METHODS We organized an “ACP Support Team for Brain Tumor Patients” and began bi-weekly ACP conferences. We analyzed 79 patients using the achievement rate of each ACP step and the number of times the process was repeated during hospitalization. Additionally, a questionnaire survey was conducted to assess changes in “nursing practice regarding decision support” for patients with malignant brain tumors and their families due to ACP conferences. RESULTS Forty-eight patients were supported by the leaflet, and 31 were not. Both groups mostly achieved confirmation of their priorities and selection of a decision-making representative. However, the achievement rate of discussion and documentation steps in ACP significantly improved after the leaflet’s introduction. The questionnaire survey revealed changes in nursing practices, including “intentional information gathering based on the progress of the brain tumor,” “reflection on nursing practice,” “sharing the patient’s intention with the whole team,” and a “positive attitude toward ACP practice.” CONCLUSION The brain tumor-specific ACP leaflet was effective in supporting ACP for brain tumor patients. Additionally, the ACP conference raised awareness of the importance of ACP in nursing practice from the early stages of the disease. Multidisciplinary cooperation played a crucial role in decision-making support.