Building Nursing Home Staff Knowledge and Confidence in Communicating About Advance Care Planning

BACKGROUND: Advance care planning is essential in nursing homes to ensure end-of-life care aligns with residents' values, yet staff often lack the knowledge and confidence to lead these discussions. METHOD: This study evaluated an advance care planning training program for 37 nursing home staff in Taiwan using a participatory action research design. The 3-month intervention included lectures, videos, role-playing, and biweekly case discussions. Data were collected at four time points (T0-T3). RESULTS: The program led to statistically significant, sustained improvements in advance care planning knowledge and communication confidence across all measurement points. Qualitative findings revealed two themes: enhanced readiness for advance care planning consultations and persistent barriers to implementation. CONCLUSION: Structured training in advance care planning can strengthen staff capacity for meaningful end-of-life discussions; however, ongoing education and case-based support remain essential to address contextual challenges and maintain communication competence.