Background: Globally, ICU patients face significant survival challenges. Many end-stage ICU patients rely solely on advanced life support to sustain vital functions, yet ultimately cannot escape mortality. This reality not only prolongs patient suffering but also imposes substantial decision-making burdens and psychological distress on families, along with severe financial strain. Advance Care Planning (ACP) offers an effective approach to mitigate these critical issues. As ICU nurses play a pivotal role in facilitating ACP conversations, enhancing their ACP-related knowledge, attitudes, and practices is essential to improve patient outcomes and family experiences. Objective: To gain an in-depth understanding of ICU nurses' knowledge, attitudes, and practical competencies regarding Advance Care Planning (ACP), and to provide a reference for implementing ACP in ICU clinical practice and developing ACP training programs for ICU nursing teams. Methods: Using a phenomenological approach in qualitative research, purposive sampling was employed to conduct semi-structured interviews with 10 ICU nurses from a tertiary Grade A hospital in Henan Province between March and May 2024. Results: Analysis of the interview data revealed four key themes:①ICU nurses have significant gaps in ACP-related knowledge,②ICU nurses exhibit divergent attitudes toward ACP implementation,③ICU nurses' ACP practical skills require improvement,④There is an urgent need for ACP education and training among ICU nurses. Conclusion: Although ICU nurses generally hold positive attitudes toward ACP implementation, their understanding and practical abilities remain limited. There is an urgent need to develop localized ACP training programs tailored for ICU nurses to enhance their ACP knowledge, skills, and professional engagement. Additionally, actively engaging in ACP discussions with critically ill patients and their families can facilitate the wider adoption and application of ACP in ICU settings

Advance Care Planning, ICU Nurses, Qualitative Research