Advance care planning in people with advanced cancer: a phenomenological study

Introduction: Significant challenges currently exist in addressing patients' preferences regarding end-of-life care, particularly in the context of advance care planning. Objective: To understand advance care planning at the end of life in people with cancer in palliative care in Medellin Colombia. Materials and Methods: This study used a hermeneutic phenomenological approach to explore the lived experiences of nine patients with advanced cancer. In-depth interviews were conducted, focusing on patients' understanding of advanced care planning. Data was analyzed using thematic analysis to identify major themes related to advance care planning. Results: Six key themes emerged from the data: (1) Clinging to life; (2) Decision delegation and reflective avoidance; (3) Silence to avoid suffering; (4) Resignation; (5) A quiet place; and (6) My legacy. These results describe the experiences of cancer patients in palliative care versus advanced care planning. Discussion: The findings highlight the complexity of advanced care planning in advanced cancer patients in palliative care. Conclusion: This study revealed barriers to care planning, including a lack of understanding of the palliative care process, communication difficulties, and cultural factors.