The ACA training programme to improve communication between general practitioners and their palliative care patients: development and applicability

Table 1 The ACA checklist ( A vailability- C urrent issues- A nticipating ), factors derived from our recent systematic review[6]and/or qualitative study [7]

ACA checklist	From review [source]	From qualitative study[7]
A *vailability* (of the GP for the patient):
1. taking time	X [10–16]	X
2. allowing any subject to be discussed	X [2, 14, 15, 17, 18]	X
3. active listening	X [14–17, 19–21]	X
4. facilitating behaviour (e.g. empathic, respectful, attentive, occasionally also phoning or visiting the patient spontaneously)	X [2, 10–17, 19–23]	X
5. shared decision-making with regard to diagnosis and treatment plan	X [13, 17, 20, 24, 25]	X
6. accessibility (e.g. phone numbers)	X [11, 13, 14, 23]	X
C *urrent issues* (that should be raised by the GP):
7. diagnosis	X [10, 13, 15, 17, 20, 24–28]	X
8. prognosis	X [10, 13, 15–17, 20, 24–28]	X
9. patient’s complaints and worries:- physical	-	X
10. - psychosocial	X [13, 18, 25, 28]	X
11. - spiritual	X [22, 28, 29]	X
12. wishes for the present and the coming days	-	X
13. unfinished business, bringing life to a close	-	X
14. discussing treatment and care options (concerning 7–13)	X [13, 17, 19, 24, 25, 28]	X
A *nticipating* (various scenarios):
15. offering follow-up appointments	-	X
16. possible complications	X [28]	-
17. wishes for the coming weeks/months (personal wishes as well as preferences with regard to medical decisions)	X [17, 19, 21, 28]	X
18. the actual process of dying (final hours/days)	X [11, 14, 18, 21, 22, 25]	-
19. end-of-life decisions	X [14, 19, 21, 28]	X

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