Bereaved Family ACP Participation Boosts Own Planning and Interpersonal Trust

Advance care planning (ACP) serves as a cornerstone of high-quality oncology care by facilitating the documentation of patient preferences and increasing the utilization of palliative services [1]. Meta-analytic data involving 14 studies indicate that while these interventions significantly increase advance directive completion (OR 7.93; 95% CI, 2.76 to 22.77) and palliative care use (OR 1.39), they may not directly alleviate patient anxiety or depression [1]. Clinicians often utilize motivational interviewing (a goal-oriented counseling style that helps patients resolve ambivalence about end-of-life decisions) to improve patient readiness for appointing a healthcare proxy (p = 0.005) and discussing preferences with family members (p = 0.006) [2]. Furthermore, structured support led by lay health workers has demonstrated durable clinical benefits, including a 25% reduction in the risk of death (HR 0.75; 95% CI, 0.56 to 0.98) and a substantial decrease in median total healthcare costs from $18,520 to $1,637 [3]. Despite these systemic benefits, the clinical focus frequently remains limited to the patient's immediate end-of-life period, leaving the subsequent behavioral and psychological trajectory of bereaved survivors under-examined. The current study investigates how active participation in a loved one's end-of-life planning influences the survivors' own health behaviors and interpersonal relationships.