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.
Chen et al. (Thu,) studied this question.