Efficacy of a Multi-Modal Educational Intervention on Advance Directive Completion and Related Factors among Outpatient Veterans

2.50
Hdl Handle:
http://hdl.handle.net/10755/149272
Type:
Presentation
Title:
Efficacy of a Multi-Modal Educational Intervention on Advance Directive Completion and Related Factors among Outpatient Veterans
Abstract:
Efficacy of a Multi-Modal Educational Intervention on Advance Directive Completion and Related Factors among Outpatient Veterans
Conference Sponsor:Sigma Theta Tau International
Conference Year:2003
Author:Hemmer Goodreau, Sueane, RN, ND, CFNP
P.I. Institution Name:Ithaca VA Community Based Outpatient
In an effort to improve end-of-life care in this country and safeguard peoples' rights during critical illness and decisional incapacity, advance directives (ADs) have gained wide acceptance as a mechanism by which people can formally document their wishes and values regarding future medical care. The rate of AD completion has remained low despite the 1990 federal mandate that they be addressed with every patient upon admission to a medical facility. Many studies have been conducted in the outpatient setting to determine effective strategies which promote advance care planning with patients during times of relative wellness, before the onset of a medical crisis or loss of cognitive functioning. This randomized, controlled trial with 133 outpatient veterans sought to address many of the presumed barriers to the AD process. An intensive educational intervention with lecture, videotape, and interactive dialogue to supplement written information about ADs, had no appreciable impact on veterans' execution of ADs (p=0.774) or subsequent discussions about end-of-life care (p=0.402). There was a statistically significant relationship between first-time AD completion and self-reported health status. No association was found between the veterans' age, gender, ethnicity, family structure, educational level, cognitive functioning, financial status, degree of religiosity, personal experience with critical illness, number of days hospitalized in the past year, prior discussions about future treatment preferences, or previous exposure to ADs; and the outcomes of AD completion and initiation of advance care discussions. Veterans with baseline ADs (n=31) had statistically significant differences from those without (n=100) with regards to age, days hospitalized in the past year, previous exposure to ADs, and discussions about ADs. Successful advance care planning is a complex and perplexing process and may depend in large part on primary care providers engaging patients in on-going, meaningful discussions about end-of-life care.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEfficacy of a Multi-Modal Educational Intervention on Advance Directive Completion and Related Factors among Outpatient Veteransen_GB
dc.identifier.urihttp://hdl.handle.net/10755/149272-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Efficacy of a Multi-Modal Educational Intervention on Advance Directive Completion and Related Factors among Outpatient Veterans</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2003</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Hemmer Goodreau, Sueane, RN, ND, CFNP</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Ithaca VA Community Based Outpatient</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Sueane.Goodreau@med.va.gov</td></tr><tr><td colspan="2" class="item-abstract">In an effort to improve end-of-life care in this country and safeguard peoples' rights during critical illness and decisional incapacity, advance directives (ADs) have gained wide acceptance as a mechanism by which people can formally document their wishes and values regarding future medical care. The rate of AD completion has remained low despite the 1990 federal mandate that they be addressed with every patient upon admission to a medical facility. Many studies have been conducted in the outpatient setting to determine effective strategies which promote advance care planning with patients during times of relative wellness, before the onset of a medical crisis or loss of cognitive functioning. This randomized, controlled trial with 133 outpatient veterans sought to address many of the presumed barriers to the AD process. An intensive educational intervention with lecture, videotape, and interactive dialogue to supplement written information about ADs, had no appreciable impact on veterans' execution of ADs (p=0.774) or subsequent discussions about end-of-life care (p=0.402). There was a statistically significant relationship between first-time AD completion and self-reported health status. No association was found between the veterans' age, gender, ethnicity, family structure, educational level, cognitive functioning, financial status, degree of religiosity, personal experience with critical illness, number of days hospitalized in the past year, prior discussions about future treatment preferences, or previous exposure to ADs; and the outcomes of AD completion and initiation of advance care discussions. Veterans with baseline ADs (n=31) had statistically significant differences from those without (n=100) with regards to age, days hospitalized in the past year, previous exposure to ADs, and discussions about ADs. Successful advance care planning is a complex and perplexing process and may depend in large part on primary care providers engaging patients in on-going, meaningful discussions about end-of-life care.</td></tr></table>en_GB
dc.date.available2011-10-26T09:59:13Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T09:59:13Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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