2.50
Hdl Handle:
http://hdl.handle.net/10755/161105
Type:
Presentation
Title:
A Patient-Centered Approach to Advance Care Planning
Abstract:
A Patient-Centered Approach to Advance Care Planning
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2006
Author:Kirchhoff, Karin, PhD, RN, FAAN
P.I. Institution Name:University of Wisconsin - Madison
Title:Professor
Contact Address:School of Nursing, 600 Highland Ave., Madison, WI, 53792, USA
Contact Telephone:608 263-0927
Co-Authors:Bernard Hammes, PhD; Karen A. Kehl, MS, RN, Predoctoral Student; and Linda A. Briggs, MS, MA, RN, Assistant Director
The Patient-Centered Approach to Advance Care Planning (PC-ACP) interview is a facilitation of discussion with the patient and surrogate, designed to elicit patients' preferences, values, and wishes concerning future medical care.

Purpose: To test the efficacy of PC-ACP on patient and surrogate outcomes immediately following the intervention and at the time of surrogate decision-making.

Theoretical/Conceptual Framework: The Interactive Decision-making Model and Donovan and Ward's Representational Approach to patient education guided the intervention and measurements.

Subjects: Subjects are adults with end-stage renal or congestive heart failure and their surrogates.

Method: Patient/surrogate pairs complete baseline questionnaires and are randomized. Pairs assigned to usual care receive standard advance directive care. In the intervention group a trained facilitator interviews patients in the presence of their surrogate. Both groups complete questionnaires on knowledge of ACP, the patient's care preferences, decisional conflict and quality of clinician communication. If the patient is subsequently unable to make medical decisions, data will be collected from the surrogate and the medical record to determine if care received was consistent with patient wishes. Decisional conflict and the impact of the event on the surrogate will also be measured.

Results and Conclusions: Interim analysis of 125 pairs shows a significant increase (p >/< 0.05) in congruence between the patient and surrogate on all five situations of treatment preference. The intervention group has a higher degree of satisfaction with the quality of communication (p >/< 0.01) and less decisional conflict (p >/< 0.05). Thus far, in 21 deaths or events, all patients in the intervention group received care that was in accord with their preferences; but in the control group only 33.33% (4/12) did. In 25% (3/12) of the usual care cases it could not be determined if care was in accord and in 41.67% (5/12) it was not. [Poster Presentation]
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 Planningen_GB
dc.identifier.urihttp://hdl.handle.net/10755/161105-
dc.description.abstract<table><tr><td colspan="2" class="item-title">A Patient-Centered Approach to 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">Kirchhoff, Karin, PhD, RN, FAAN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Wisconsin - Madison</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">School of Nursing, 600 Highland Ave., Madison, WI, 53792, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">608 263-0927</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">ktkirchhoff@wisc.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Bernard Hammes, PhD; Karen A. Kehl, MS, RN, Predoctoral Student; and Linda A. Briggs, MS, MA, RN, Assistant Director</td></tr><tr><td colspan="2" class="item-abstract">The Patient-Centered Approach to Advance Care Planning (PC-ACP) interview is a facilitation of discussion with the patient and surrogate, designed to elicit patients' preferences, values, and wishes concerning future medical care.<br/><br/>Purpose: To test the efficacy of PC-ACP on patient and surrogate outcomes immediately following the intervention and at the time of surrogate decision-making.<br/><br/>Theoretical/Conceptual Framework: The Interactive Decision-making Model and Donovan and Ward's Representational Approach to patient education guided the intervention and measurements.<br/><br/>Subjects: Subjects are adults with end-stage renal or congestive heart failure and their surrogates.<br/><br/>Method: Patient/surrogate pairs complete baseline questionnaires and are randomized. Pairs assigned to usual care receive standard advance directive care. In the intervention group a trained facilitator interviews patients in the presence of their surrogate. Both groups complete questionnaires on knowledge of ACP, the patient's care preferences, decisional conflict and quality of clinician communication. If the patient is subsequently unable to make medical decisions, data will be collected from the surrogate and the medical record to determine if care received was consistent with patient wishes. Decisional conflict and the impact of the event on the surrogate will also be measured.<br/><br/>Results and Conclusions: Interim analysis of 125 pairs shows a significant increase (p &gt;/&lt; 0.05) in congruence between the patient and surrogate on all five situations of treatment preference. The intervention group has a higher degree of satisfaction with the quality of communication (p &gt;/&lt; 0.01) and less decisional conflict (p &gt;/&lt; 0.05). Thus far, in 21 deaths or events, all patients in the intervention group received care that was in accord with their preferences; but in the control group only 33.33% (4/12) did. In 25% (3/12) of the usual care cases it could not be determined if care was in accord and in 41.67% (5/12) it was not. [Poster Presentation]</td></tr></table>en_GB
dc.date.available2011-10-26T23:15:59Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T23:15:59Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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