Community Dwelling Cancer Survivors' Perception and Readiness for Advance Care Planning: An Interpretive Description Qualitative Study

ABSTRACT Aim This study aimed to explore perceptions and readiness to engage in advance care planning (ACP) among community‐dwelling cancer survivors. Design An interpretive description qualitative study with reflexive thematic analysis. Methods Cancer survivors who had completed primary cancer treatment and had not previously completed ACP were recruited from community settings in Singapore. Audio‐ and video‐recorded semi‐structured online interviews were conducted. The interviews were analysed using reflexive thematic analysis. Results Twenty‐one adult cancer survivors who had completed primary cancer treatment and had not previously embarked on an ACP discussion participated in the study. Two themes and six subthemes emerged: (1) Personal and relational perceptions towards advance care planning and (2) Illness and psychosocial contexts influence readiness for advance care planning were elucidated. Participants valued ACP for preserving autonomy and reducing potential burden on their families, but often perceived its relevance as contingent on future deterioration. Perceived recovery or clinical stability could therefore position ACP as something to be deferred. Readiness to engage was further shaped by emotional preparedness, cultural and familial considerations, informational needs and healthcare‐system support. Conclusions Cancer survivors view ACP as a tool to preserve autonomy and control. Their engagement towards ACP is dynamic and shaped by relational values, sociocultural norms, and evolving perceptions of illness. Implications for the Profession and/or Patient Care Proactive, culturally sensitive and nurse‐led approaches are needed to address misconceptions, support emotional readiness and facilitate meaningful ACP discussions throughout the survivorship trajectory. Impact This study highlights a paradox in cancer survivorship whereby clinical stability may create an opportunity for ACP while simultaneously reducing its perceived relevance. Findings also suggest that overall readiness may coexist with emotional hesitation, supporting approaches to ACP that attend to personal, familial and structural dimensions of readiness rather than assuming uniform preparedness to engage.

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Publication Details

Journal
Journal of Clinical Nursing
Published
2026-10-08
DOI
https://doi.org/10.1111/jocn.70587
Primary Topic
Palliative Care and End-of-Life Issues
Type
article
Field-Weighted Citation Impact
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article

Community Dwelling Cancer Survivors' Perception and Readiness for Advance Care Planning: An Interpretive Description Qualitative Study

Terina Yan Wen Tay, Betsy Seah, Wei How Darryl Ang, Khairul Dzakirin Bin Rusli et al.
Journal of Clinical Nursing
Palliative Care and End-of-Life Issues
article

Community Dwelling Cancer Survivors' Perception and Readiness for Advance Care Planning: An Interpretive Description Qualitative Study

Terina Yan Wen Tay, Betsy Seah, Wei How Darryl Ang, Khairul Dzakirin Bin Rusli, Xi Vivien Wu, Hyojin Yoon, Melvin Tai Loong Poon, Sarina Enami
article en

Abstract

ABSTRACT Aim This study aimed to explore perceptions and readiness to engage in advance care planning (ACP) among community‐dwelling cancer survivors. Design An interpretive description qualitative study with reflexive thematic analysis. Methods Cancer survivors who had completed primary cancer treatment and had not previously completed ACP were recruited from community settings in Singapore. Audio‐ and video‐recorded semi‐structured online interviews were conducted. The interviews were analysed using reflexive thematic analysis. Results Twenty‐one adult cancer survivors who had completed primary cancer treatment and had not previously embarked on an ACP discussion participated in the study. Two themes and six subthemes emerged: (1) Personal and relational perceptions towards advance care planning and (2) Illness and psychosocial contexts influence readiness for advance care planning were elucidated. Participants valued ACP for preserving autonomy and reducing potential burden on their families, but often perceived its relevance as contingent on future deterioration. Perceived recovery or clinical stability could therefore position ACP as something to be deferred. Readiness to engage was further shaped by emotional preparedness, cultural and familial considerations, informational needs and healthcare‐system support. Conclusions Cancer survivors view ACP as a tool to preserve autonomy and control. Their engagement towards ACP is dynamic and shaped by relational values, sociocultural norms, and evolving perceptions of illness. Implications for the Profession and/or Patient Care Proactive, culturally sensitive and nurse‐led approaches are needed to address misconceptions, support emotional readiness and facilitate meaningful ACP discussions throughout the survivorship trajectory. Impact This study highlights a paradox in cancer survivorship whereby clinical stability may create an opportunity for ACP while simultaneously reducing its perceived relevance. Findings also suggest that overall readiness may coexist with emotional hesitation, supporting approaches to ACP that attend to personal, familial and structural dimensions of readiness rather than assuming uniform preparedness to engage.

Journal of Clinical Nursing
Baylor University (US), National University of Singapore (SG), Khoo Teck Puat Hospital (SG), Tokyo Health Care University (JP), Institute of Mental Health (SG)
Openalex Percentile: Top 10%
Palliative Care and End-of-Life Issues
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