Advance Care Planning in Nurse Practitioner Practice: A Cross-Sectional Descriptive Study
Bibliographic record
Abstract
It is estimated that the number of people who die of life-limiting illnesses in Canada will double by the year 2056. Advance care planning (ACP) is one way to improve the quality of end-of-life care. ACP is a process of ongoing discussions whereby a person communicates important values and desired outcomes at the end of life prior to healthcare crises. Nurse practitioners (NP) commonly diagnose and plan healthcare for patients who may have life-limiting conditions and thus are in a strategic position to engage patients in ACP. Currently, we have a poor understanding of the extent and nature of NP involvement in ACP. This descriptive study explored Ontario NPs' knowledge, beliefs and level of implementation of ACP. NPs employed in hospital settings were significantly more likely to engage in ACP with patients and to have a policy governing ACP initiation compared with their community-employed counterparts. There were no significant differences between the NPs in these two settings in the beliefs, attitudes or personal comfort in initiating ACP. Implications for education, practice and research are provided.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".