Understanding moral distress and adaptive responses of clinicians in Advance Care Planning (ACP)

Principal Investigator: Dr Raymond Ng Han Lip (Visiting Consultant, GERI; Senior Consultant and Head, Palliative & Supportive Care, Department of Integrated Care, Woodlands Health (WH))

Collaborating Organisation(s): WH, Nanyang Technological University, Khoo Teck Puat Hospital, National University of Singapore, National University Hospital

Gap: Since 2011, the Living Matters programme, based on the Respecting Choices framework for ACP, has been implemented nationwide. More research is needed to understand the moral distress that healthcare professionals face in implementing ACP in real-world settings as well as effective ways to address the ethical challenges that have arisen in practice.

Planned Solution: This mixed-methods study aims to examine the relationships among factors involved in implementing ACP, moral distress, and ethical conundrums. It will involve in-depth interviews, focus group discussions and quantitative methods to identify key issues around moral distress faced ACP facilitators and healthcare professionals.

Anticipated Impact: The findings from this study will inform the training curricula for ACP facilitators and healthcare professionals, as well as highlight potential service, knowledge and system gaps within the broader ACP service planning and operations perspective. Findings have been presented at six local and international scientific conferences, most recently the 2024 British Geriatrics Society Autumn Meeting and Singapore Health and Biomedical Congress 2024.

Duration: Mar 2022 to May 2025