Research Projects

Research Projects

Current research projects that we are leading

Improving public engagement in Advance Care Planning through peer-facilitated group activities

Project Summary:
Advance Care Planning (ACP) encourages us all to be more actively involved in decision making about healthcare. Although ACP is something we can do on our own, we often require support from others. Most studies in ACP have focused on experts within the healthcare system.

In this study, we will look at new ways to support members of the public to think and talk about what matters in relation to getting older and adjusting to changes in health. We will train members of the public who volunteer at community organisations to support group ACP activity sessions. The sessions aim to inform, promote conversation, and break down barriers and stigmas around these conversations. We will invite older adults and their caregivers and families to attend the sessions.

As the sessions are run by trained volunteers rather than experts, we will look at the volunteers’ experiences. We will ask them how they felt running the sessions, what worked and what needs to be improved. We will also study how best to encourage older adults to come to the sessions. Lastly, we will look at whether the activities help older adults be more involved in ACP activities and conversations. We will look at whether the sessions increase their comfort with the conversation, help them identify what matters to them, and help them talk about it with their family and healthcare providers.
Our findings will help improve future community-based ACP education and activities.

Principal Investigator: Doris Barwich, Jennifer Kryworuchko, Arminee Kazanjian.
Co-Investigators: Eman Hassan, Pippa Hawley, Katherine Kortes-Miller, Richard Sawatzky, Jessica Simon, Shimae Soheilipour, Kelli Stajduhar.
Project Manager: Rachel Carter.
Researchers: Lawrence Mroz, Amber Husband
Dates: April 2016 – April 2017
Funding Agency: Canadian Frailty Network (Technology Evaluation in the Elderly Network), BC CPC


An exploration of men’s and women’s experiences of advance care planning engagement tools and surveys.
Project Summary:
Advance care planning (ACP) is important for frail seniors. It allows them to think and talk about their values, goals and healthcare wishes. It also ensures that these wishes are followed at times where they cannot make decisions themselves. However, few frail seniors have conducted ACP.

ACP and decision-­‐support tools include workshops, online/printed workbooks and guides. Not all tools meet the needs of the users. Several studies across Canada are hoping to find tools that are useful, promote awareness and knowledge, and assist users in the ACP conversation. An ACP engagement survey is being used to measure this.

We do not know if men and women approach and experience ACP differently. Differences have been found for health issues such as nutrition and these differences may also exist for ACP. If men and women interpret ACP issues differently the tools may not be equally effective at assisting them to engage in ACP, and the survey may not be equally effective at measuring their ACP experiences.

Men diagnosed with prostate cancer and their female partners will attend an ACP workshop and complete an ACP engagement survey. They will then be asked about their experiences with the tool, and their interpretation of the survey questions. This will look at how men and women understand ACP and how they interpret the questions in the survey.

Using gender to look at people’s experience of ACP is a new approach. The findings will inform ACP tool and tool evaluation development, improving ACP for all frail seniors.

Interdisciplinary Fellow: Lawrence Mroz
Supervisors: Richard Sawatzky, Doris Barwich
Dates: January 2016 – December 2016
Funding Agency: Canadian Frailty Network (Technology Evaluation in the Elderly Network), BC CPC


Research Projects we are involved in

Primary Care and Advance Care Planning (i-GAP)
Role: Co-investigator, collection of data in BC.
Dates: April 2014- March 2016
Funding agency: Canadian Frailty Network (Technology Evaluation in the Elderly Network)
Principal Investigators: Daren Heyland, Michelle Howard

Improving decision-making about goals of care for hospitalized, elderly patients (iDECIDE)
Role: Knowledge User
Funding Agency:
Principal Investigators:

Development and Validation of a Patient Reported Measure of Compassionate Care
Role: Knowledge User
Dates: July 2016- June 2020
Funding Agency: CIHR
Principal Investigators: Shane Sinclair, Richard Sawatzky, Thomas Hack

An integrated knowledge translation approach to examining a model of volunteer navigation (NCARE) to support older adults living with advance chronic illness in the home
Role: Principal Applicant
Dates: July 2016 – June 2019
Funding agency: CIHR
Principal Investigators: Barbara Pesut, Doris Barwich, Wendy Duggleby


Past Research Projects

A Knowledge Translation Project on the Benchmark End of Life Care Practices for the Elderly in Primary Care
Role: Knowledge User
Dates: March 2013 – March 2015
Funding Agency: Canadian Frailty Network (Technology Evaluation in the Elderly Network)
Principal Investigators: Francis Lau

The ACCEPT study: Advance Care Planning Evaluation in Hospitalized Elderly Patients: A multi-center prospective study
Role: Knowledge User, Principal Applicant, Co Applicant
Dates: March 2011 – March 2014
Funding Agency: CIHR, Michael Smith Foundation for Health Research, Alberta Innovates, Health solutions
Principal Investigator: Daren Heyland

Family Caregiver Coping in End of Life Cancer Care
Role: Co-Investigator
Dates: July 2004 – June 2008
Funding Agency: National Cancer Institute of Canada
Principal Investigator: Kelli Stadjuhar


Research Publications: Peer-reviewed Articles

Tasmin Sinuff, Peter Dodek, John You, Doris Barwich, Carolyn Tayler, James Downar, Michael Hartwick, Christopher Frank, Henry Stelfox, Daren Heyland. (2015). Improving End-of-life Communication and Decision Making: The Development of a Conceptual Framework and Quality Indicators. Journal of Pain and Symptom Management. 49(6): 1070-1080.

Francis Lau, Doris Barwich, Neil Hilliard, Colin Partridge, Bruce Hodson, Morgan Price, Douglas McGregor, Jesdeep Bassi, Dennis Lee, Jilie kom, Joanna Pyke, Gurpirt Randhawa. (2015). A Knowledge Translation Project on Best Practices in End of Life Care. Studies in Health technology and informatics. 02/2015(208): 237-241.

Jessica Simon, Eric Wasylenko, Doris Barwich. (2014). Beyond resuscitate and do-not-resuscitate. Canadian Medical Association Journal. 12/2014(186): 1398

Carolyn Tayler, Louise Hanvey, Ana Teixeira, Doris Barwich, S Baxter, D k Heyland. (2013). Engagement in Advance Care Planning: Do Region-wide interventions work? Supportive and Palliative Care. 06/2013(3(2)): 233-234.

Ana Teixiera, Louise Hanvey, Carolyn Tayler, Doris Barwich, Sharon Baxter, Daren Heyland. (2013). What do Canadians think of Advance Care Planning? Findings from an on-line opinion poll. Supportive and Palliative Care. 10/2013(5): 1-8.

Heyland DK , Barwich D , Pichora D , Dodek P , Lamontagne F , You JJ , Tayler C , Porterfield P , Sinuff T, Simon J. (2013). Failure to Engage Hospitalized Elderly Patients and Their Families in Advance Care Planning. JAMA internal medicine. 173(9): 778-87.

Heyland DK, Pichora D, Dodek P, Lamontagne F, You JJ, Barwich D, Tayler C, Porterfield P, Simon J, Enns B. (2012) The Development and Validation of a Questionnaire to Audit Advance Care Planning. J Palliative Care Med 2:119. doi:10.4172/2165-7386.1000119

Clelland, C., Barwich, D., McGregor, D.(2012). Implementing the British Columbia Practice Support Program in End of Life care. BMJ Supportive and Palliative Care. 2(2): 179.

McGregor, D., Clelland, C., Barwich, D., Porterfield, P., Hoffmann, C. (2012). Designing Advance Care (Incapacity) Planning and Advance Directives Legislation in British Columbia. BMJ Supportive and Palliative Care. 2(2): 177.

You, JJ., Heyland, D., Dodek, P., Lamontagne, F., Barwich, D., Tayler, C., Porterfield, P., Simon, J.(2012). Opportunities to Improve End-of-Life Care Communication and Decision-making for Seriously Ill Patients and Their Families. BMJ Supportive and Palliative Care. 2(2): 190.

Doris Barwich. (2012). When and How to die. Canadian Medical Association. 11/2012(184): 1814-1815.

Hawley,P., Barwich,D., Kirk,L.(2011). Implementation of the Victoria Bowel Performance Scale. Journal of Pain and Symptom Management. 42(6): 946-953.

Stajduhar, K., Martin, W., Barwich, D., Fyles, G.(2008). Factors Influencing Family Caregivers’ Ability to Cope With Providing End-of-Life Cancer Care at Home. Cancer Nursing. 31(1): 77-85.

Grant, S., Rush, J., Barwich, D., Tayler, C.(2007). Advance Care Planning: What’s All the Talk About? The Canadian Journal of Medical Radiation Technology. 38(4): 5-10.

Roberts D , Tayler C , MacCormack D , Barwich D. (2007). Telenursing in hospice palliative care. The Canadian nurse. 103(5),24-7


Research Publications: Conference Presentations

Seed Grants Grow Community Capacity for Better End of Life Care and Experience. Eman Hassan, Terry Webber. Oral Presentation, BCHPCA Conference 2016, May 2016

A Whole Systems and Societal Approach to Pursue Excellence in Palliative Care in BC. Doris Barwich, Eman Hassan, Kathleen Yue, Laura Spencer, Terry Webber, et al. Oral Presentation, 21st International Congress on Palliative Care, October 2016

Compassionate Communities: How Do We Get There? Eman Hassan, Doris Barwich, Terry Webber. Oral Presentation, 21st International Congress on Palliative Care, October 2016

The British Columbia (BC) education plan for an integrated palliative approach to care – moving through conflict, consensus and collaboration to synergy. Kathleen Yue. Poster Presentation, 21st International Congress on Palliative Care, October 2016

It’s Remarkable! Lessons Learned in Enabling Excellence in Advance Care Planning Across British Columbia. Doris Barwich, Laura Spencer, Sue Grant. Poster Presentation, 21st International Congress on Palliative Care, October 2016

Empowering Communities through Development of a Volunteer Facilitated ACP Public Workshop. Sue Grant, Pat Porterfield, Terry Webber, Laura Spencer, Rachel Carter, Eman Hassan, Doris Barwich. Oral Presentation, 21st International Congress on Palliative Care, October 2016

Men’s and Women’s Experiences of Advance Care Planning Workshops. Lawrence Mroz, Rick Sawatzky, Doris Barwich, Jennifer Kryworuchko, Rachel Carter, Laura Spencer. Poster Presentation, 6th International Seminar of the PRC and EAPC RN, December 2016

Public participants’ experience of volunteer peer facilitated ACP workshops. Rachel Carter, Jennifer Kryworuchko, Amber Husband, Doris Barwich. Poster Presentation, 6th International Seminar of the PRC and EAPC RN, December 2016