Implementing a Pilot Program of Advanced Directives in Nursing Homes

Chovan, William L.

doi:10.2466/pr0.100.1.195-198

Cited by 6 publications

(3 citation statements)

References 7 publications

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“…Most programs were evaluated in one study [31][32][33][47][48][49]56,57], two studies evaluated MyDirectives [38,46], seven studies evaluated PREPARE [38,[50][51][52][53][54][55], and 12 studies evaluated Making Your Wishes Known in [34][35][36][37][38][39][40][41][42][43][44][45]. Multimedia Appendix 3 presents an overview of the characteristics of the studies.…”

Section: Evaluation Of the Web-based Advance Care Planning Programsmentioning

confidence: 99%

“…All studies were published in the period from 2007 to 2018, of which nine studies were published in 2017. In total, 25 of the studies have a quantitative design [31,[33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][51][52][53][54][55][56][57], and two study designs are qualitative [32,50]. Nine studies allowed comparison of outcomes before/after an intervention [31,35,40,42,43,45,[53][54][55], and eight studies allowed comparison between intervention and control groups [31,39,45,49,52,[54][55][56].…”

Section: Evaluation Of the Web-based Advance Care Planning Programsmentioning

confidence: 99%

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The Feasibility and Effectiveness of Web-Based Advance Care Planning Programs: Scoping Review

et al. 2020

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Background Advance care planning (ACP) is a process with the overall aim to enhance care in concordance with patients’ preferences. Key elements of ACP are to enable persons to define goals and preferences for future medical treatment and care, to discuss these with family and health care professionals, and to document and review these if appropriate. ACP is usually conducted through personal conversations between a health care professional, a patient, and—if appropriate—family members. Although Web-based ACP programs have the potential to support patients in ACP, their effectiveness is unknown. Objective This study aimed to assess the feasibility and effectiveness of Web-based, interactive, and person-centered ACP programs. Methods We systematically searched for quantitative and qualitative studies evaluating Web-based, interactive, and person-centered ACP programs in seven databases including EMBASE, Web of Science, Cochrane Central and Google Scholar. Data on the characteristics of the ACP programs’ content (using a predefined list of 10 key elements of ACP), feasibility, and effectiveness were extracted using a predesigned form. Results Of 3434 titles and abstracts, 27 studies met the inclusion criteria, evaluating 11 Web-based ACP programs—10 were developed in the United States and one in Ireland. Studied populations ranged from healthy adults to patients with serious conditions. Programs typically contained the exploration of goals and values (8 programs), exploration of preferences for treatment and care (11 programs), guidance for communication about these preferences with health care professionals or relatives (10 programs), and the possibility to generate a document in which preferences can be recorded (8 programs). Reportedly, participants were satisfied with the ACP programs (11/11 studies), considering them as easy to use (8/8 studies) and not burdensome (7/8 studies). Designs of 13 studies allowed evaluating the effectiveness of five programs. They showed that ACP programs significantly increased ACP knowledge (8/8 studies), improved communication between patients and their relatives or health care professionals (6/6 studies), increased ACP documentation (6/6 studies), and improved concordance between care as preferred by the patients and the decisions of clinicians and health care representatives (2/3 studies). Conclusions Web-based, interactive, and person-centered ACP programs were mainly developed and evaluated in the United States. They contained the key elements of ACP, such as discussing and documenting goals and preferences for future care. As participants considered programs as easy to use and not burdensome, they appeared to be feasible. Among the 13 studies that measured the effectiveness of programs, improvement in ACP knowledge, communication, and documentation was reported. The concordance between preferred and received care is yet understudied. Studies with high-quality study designs in different health care settings are warranted to further establish the feasibility and effectiveness of Web-based ACP programs.

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Section: Evaluation Of the Web-based Advance Care Planning Programsmentioning

confidence: 99%

Section: Evaluation Of the Web-based Advance Care Planning Programsmentioning

confidence: 99%

The Feasibility and Effectiveness of Web-Based Advance Care Planning Programs: Scoping Review

et al. 2020

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“…However, it can help prepare care recipients and care partners for such conversations. A review of 11 web-based advance care planning interventions (e.g., Death over Dinner [ 111 ], Five Wishes [ 112 ], Making Your Wishes Known [ 113 ], PREPARE for Your Care [ 114 ] showed improved advance care planning knowledge, communication, and documentation [ 63 ]. However, we are aware that no web-based intervention focused on advance care planning in the context of dementia [ 86 ].…”

Section: Methodsmentioning

confidence: 99%

Promoting Advance Care Planning for Persons with Dementia: Study Protocol for the LEAD (Life-Planning in Early Alzheimer’s and Other Dementias) Clinical Trial

Dassel¹,

Iacob²,

Utz³

et al. 2023

OBM Integr Complement Med

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Due to the insidious progression of Alzheimer's disease and related dementias (ADRD), surrogate decision-makers typically make medical and long-term-care decisions for a care recipient, most often a family care partner. Unfortunately, many care recipient/care partner dyads have failed to engage in advance care planning or have lost the opportunity to do so due to the cognitive decline of the care recipient. To address this need, our team created a validated dementia-focused advance care planning tool known as the LEAD Guide (Life-Planning in Early Alzheimer’s and Other Dementias). With funding from the National Alzheimer's Association and in consultation with our community advisory board, we developed a preliminary web-based intervention. This intervention integrates the LEAD Guide with self-paced educational modules that lead dyads through conversations and dementia-focused advance care planning processes. In this concept paper, we describe the aims of our funded R01 clinical trial (National Institute on Aging), where we aim to refine our preliminary web-based platform for use in a 5-month mixed-method NIH Stage-1 behavioral intervention. Using a sample of diverse community-based ADRD dyads (n = 60), we aim to: 1) describe the acceptability, usability, and feasibility of the intervention, 2) assess the initial efficacy of the intervention on the primary outcome (decision-making self-efficacy), and secondary outcomes (relationship quality, subjective well-being, anxiety) as perceived by both the care recipient and the care partner, and 3) examine advance care planning congruence as a mechanism of action. The LEAD clinical trial addresses public health challenges by guiding and supporting families through challenging advance care planning conversations, facilitating the transfer of knowledge regarding care preferences and values from the care recipient to the care partner, with the ultimate goal of improving the quality of life for both individuals with ADRD and their care partners.

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Palliative Care in Liver Transplantation, When to Consult a Specialist

Sagin¹,

O’Connor²

2015

Contemporary Liver Transplantation

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Implementing a Pilot Program of Advanced Directives in Nursing Homes

Cited by 6 publications

References 7 publications

The Feasibility and Effectiveness of Web-Based Advance Care Planning Programs: Scoping Review

The Feasibility and Effectiveness of Web-Based Advance Care Planning Programs: Scoping Review

Promoting Advance Care Planning for Persons with Dementia: Study Protocol for the LEAD (Life-Planning in Early Alzheimer’s and Other Dementias) Clinical Trial

Palliative Care in Liver Transplantation, When to Consult a Specialist

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