2.50
Hdl Handle:
http://hdl.handle.net/10755/160894
Type:
Presentation
Title:
Patient-Centered Advance Care Planning
Abstract:
Patient-Centered Advance Care Planning
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2006
Author:Song, Mi-Kyung, PhD, RN
P.I. Institution Name:University of Pittsburgh
Title:Assistant Professor
Contact Address:Faculty of Nursing, 3500 Victoria Street, 336VB, Pittsburgh, PA, 15261, USA
Contact Telephone:412-624-4769
Co-Authors:Karin T. Kirchhoff, PhD, RN, FAAN, Professor; Jeffrey Douglas, PhD, Associate Professor; Sandra E. Ward, PhD, RN, FAAN; and Bernard Hammes, PhD
Surgical patients and their families generally have insufficient knowledge to make plans in case of life-threatening complications.

The purpose of this study was to test short-term effects of Patient-Centered Advance Care Planning (PC-ACP), a representational intervention, developed to improve communication about end-of-life care among patients undergoing cardiac surgery.

PC-ACP is based on the 5 stages of the Representational Approach. Compared to the standard care for advance care planning focusing on the completion of legal documents, PC-ACP provides both patient and surrogate decision maker opportunity to reflect on the illness severity and progression, including the risk for sudden complications after surgery (Stages 1 & 2). This process opens the door for all parties (the patient, surrogate, and clinician) to identify gaps, confusions, and misconceptions related to the patient's medical condition and end-of-life planning (Stage 3). Using this information, the clinician is able to provide individualized new information that is relevant and specific to the dyads' representations. This information includes potential complications, the kinds of treatment decisions the surrogate might be asked to make, and benefits and burdens of life-sustaining treatment (Stage 4). The clinician discusses with the dyad regarding the expected benefits of the patient and dyad acting together with the new information (Stage 5).

Thirty-two patient-surrogate dyads were randomly assigned to receive either PC-ACP or usual care. Outcome variables included patient-surrogate congruence regarding goals for future medical care, anxiety, patients' decisional conflict, and patients' and surrogates' knowledge of advance care planning. Compared to usual care, the dyads in PC-ACP significantly improved in patient-surrogate congruence, and showed a reduction in patients' decisional conflict. Pre-post anxiety did not differ between the two groups.

In this study, the PC- ACP was an effective approach to help patients articulate wishes and make plans for future medical care based upon their illness experiences and beliefs.
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.titlePatient-Centered Advance Care Planningen_GB
dc.identifier.urihttp://hdl.handle.net/10755/160894-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Patient-Centered Advance Care Planning</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">2006</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Song, Mi-Kyung, PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Pittsburgh</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">Faculty of Nursing, 3500 Victoria Street, 336VB, Pittsburgh, PA, 15261, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">412-624-4769</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">songm@pitt.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Karin T. Kirchhoff, PhD, RN, FAAN, Professor; Jeffrey Douglas, PhD, Associate Professor; Sandra E. Ward, PhD, RN, FAAN; and Bernard Hammes, PhD</td></tr><tr><td colspan="2" class="item-abstract">Surgical patients and their families generally have insufficient knowledge to make plans in case of life-threatening complications. <br/><br/>The purpose of this study was to test short-term effects of Patient-Centered Advance Care Planning (PC-ACP), a representational intervention, developed to improve communication about end-of-life care among patients undergoing cardiac surgery. <br/><br/>PC-ACP is based on the 5 stages of the Representational Approach. Compared to the standard care for advance care planning focusing on the completion of legal documents, PC-ACP provides both patient and surrogate decision maker opportunity to reflect on the illness severity and progression, including the risk for sudden complications after surgery (Stages 1 &amp; 2). This process opens the door for all parties (the patient, surrogate, and clinician) to identify gaps, confusions, and misconceptions related to the patient's medical condition and end-of-life planning (Stage 3). Using this information, the clinician is able to provide individualized new information that is relevant and specific to the dyads' representations. This information includes potential complications, the kinds of treatment decisions the surrogate might be asked to make, and benefits and burdens of life-sustaining treatment (Stage 4). The clinician discusses with the dyad regarding the expected benefits of the patient and dyad acting together with the new information (Stage 5).<br/><br/>Thirty-two patient-surrogate dyads were randomly assigned to receive either PC-ACP or usual care. Outcome variables included patient-surrogate congruence regarding goals for future medical care, anxiety, patients' decisional conflict, and patients' and surrogates' knowledge of advance care planning. Compared to usual care, the dyads in PC-ACP significantly improved in patient-surrogate congruence, and showed a reduction in patients' decisional conflict. Pre-post anxiety did not differ between the two groups. <br/><br/>In this study, the PC- ACP was an effective approach to help patients articulate wishes and make plans for future medical care based upon their illness experiences and beliefs.</td></tr></table>en_GB
dc.date.available2011-10-26T23:12:29Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T23:12:29Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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