2.50
Hdl Handle:
http://hdl.handle.net/10755/159370
Type:
Presentation
Title:
A Patient-centered Approach to Advance Care Planning: Pilot Study
Abstract:
A Patient-centered Approach to Advance Care Planning: Pilot Study
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2003
Author:Kirchhoff, Karin
Contact Address:SON, K6/358 CSC, 600 Highland Ave, Madison, WI, 53792, USA
Co-Authors:Linda A Bringgs; Bernard J. Hammes; Mi-Kyung Song; Elaine R. Colvin
Purpose: To test the feasibility of a Patient-Centered Advance Care Planning (PC-ACP) intervention on shared decision-making for patients with chronic illness. Conceptual framework and intervention: A Representational Approach to patient education formed the conceptual model for the intervention, namely the patient-centered advance care planning (PC-ACP) interview. The Representational Approach was applied to the ACP model promoted in the nationally recognized program, Respecting Choices. Design: An experimental post-test study design. Subjects: The three special populations of patients chosen for this study were end-stage congestive heart failure (CHF), end-stage renal disease (ESRD), and preoperative open-heart surgery (OHS). Of a total of 27 patients, 13 were assigned to the experimental (E) group (4 OHS, 4 CHF, and 5 ESRD), and 14 were allocated to the control (C) group (4 OHS, 5 CHF, and 5 ESRD). Method: Following assessments of demographics and chart audits, the E group’s patient-surrogate pairs received a PC-ACP interview as an intervention. Outcome measures included the Statement of Treatment Preferences, Knowledge about Advance Care Planning, Decisional Conflict Scale, and the Quality of Patient-clinician Communication about End-of-life Care. Results: About 85% of the E group’s surrogates changed their decisions regarding patient’s future medical care at least in one situation of Statement of Treatment Preferences following the PC-ACP interview. The E group’s congruence in specific treatment preferences between patient and surrogate was higher than the C group (p=.008). Compared to the C group, experimental patients demonstrated higher satisfaction with the quality of patient-clinician communication (p=.043) and lower decisional conflict regarding preferences for future medical care (p=.004). Conclusions: The PC-ACP interview can positively impact shared decision-making between patient and surrogate while decreasing decisional conflict. Findings from this study may provide a framework for advance care planning that can be replicated in other chronic illnesses and special patient populations. AN: MN030064
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleA Patient-centered Approach to Advance Care Planning: Pilot Studyen_GB
dc.identifier.urihttp://hdl.handle.net/10755/159370-
dc.description.abstract<table><tr><td colspan="2" class="item-title">A Patient-centered Approach to Advance Care Planning: Pilot Study</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</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">Kirchhoff, Karin</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">SON, K6/358 CSC, 600 Highland Ave, Madison, WI, 53792, USA</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Linda A Bringgs; Bernard J. Hammes; Mi-Kyung Song; Elaine R. Colvin</td></tr><tr><td colspan="2" class="item-abstract">Purpose: To test the feasibility of a Patient-Centered Advance Care Planning (PC-ACP) intervention on shared decision-making for patients with chronic illness. Conceptual framework and intervention: A Representational Approach to patient education formed the conceptual model for the intervention, namely the patient-centered advance care planning (PC-ACP) interview. The Representational Approach was applied to the ACP model promoted in the nationally recognized program, Respecting Choices. Design: An experimental post-test study design. Subjects: The three special populations of patients chosen for this study were end-stage congestive heart failure (CHF), end-stage renal disease (ESRD), and preoperative open-heart surgery (OHS). Of a total of 27 patients, 13 were assigned to the experimental (E) group (4 OHS, 4 CHF, and 5 ESRD), and 14 were allocated to the control (C) group (4 OHS, 5 CHF, and 5 ESRD). Method: Following assessments of demographics and chart audits, the E group&rsquo;s patient-surrogate pairs received a PC-ACP interview as an intervention. Outcome measures included the Statement of Treatment Preferences, Knowledge about Advance Care Planning, Decisional Conflict Scale, and the Quality of Patient-clinician Communication about End-of-life Care. Results: About 85% of the E group&rsquo;s surrogates changed their decisions regarding patient&rsquo;s future medical care at least in one situation of Statement of Treatment Preferences following the PC-ACP interview. The E group&rsquo;s congruence in specific treatment preferences between patient and surrogate was higher than the C group (p=.008). Compared to the C group, experimental patients demonstrated higher satisfaction with the quality of patient-clinician communication (p=.043) and lower decisional conflict regarding preferences for future medical care (p=.004). Conclusions: The PC-ACP interview can positively impact shared decision-making between patient and surrogate while decreasing decisional conflict. Findings from this study may provide a framework for advance care planning that can be replicated in other chronic illnesses and special patient populations. AN: MN030064 </td></tr></table>en_GB
dc.date.available2011-10-26T21:57:08Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T21:57:08Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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