SPIRIT trial: A phase III pragmatic trial of an advance care planning intervention in ESRD

Song, Mi‐Kyung; Unruh, Mark; Manatunga, Amita K.; Plantinga, Laura C.; Lea, Janice; Jhamb, Manisha; Kshirsagar, Abhijit V.; Ward, Sandra E.

doi:10.1016/j.cct.2017.10.005

Cited by 16 publications

(34 citation statements)

References 52 publications

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“…It will also require that providers reflect on the unintended effects of their own actions as agents within the health system (18,19,36). Equipping providers to engage in such reflection will require that we reshape medical training and practice to place a higher premium on emotional intelligence (37), the narratives of individual patients (17,19,38), and person-centered approaches to care (e.g., listening, relationship-building, care coordination, shared decisionmaking, peer support) (9,19,(39)(40)(41)(42)(43)(44)(45)(46)(47).…”

Section: Discussionmentioning

confidence: 99%

Emotional Impact of Illness and Care on Patients with Advanced Kidney Disease

O’Hare

Richards

Szarka

et al. 2018

CJASN

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Section: Discussionmentioning

confidence: 99%

Emotional Impact of Illness and Care on Patients with Advanced Kidney Disease

O’Hare

Richards

Szarka

et al. 2018

CJASN

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“…Moreover, it can deter conflicts amongst patients and their family members and healthcare providers [20,21] and reduce unnecessary hospitalization or transferring to intensive care units [22]. Furthermore, healthcare provider-initiated ACP conversations with patients and their surrogates significantly improved patients' preparation for EOL decision-making [23] and completion of AD [24].…”

Section: Introductionmentioning

confidence: 99%

The explorations of the awareness, contemplation, self-Efficacy, and readiness of advance care planning, and its predictors in Taiwanese patients while receiving hemodialysis treatment

Chen

et al. 2022

BMC Palliat Care

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Background End-stage renal disease (ESRD) is a major chronic illness worldwide, and Taiwan reports one of the highest incidence rates of ESRD with 529 cases per million population (pmp). A number of patients with ESRD patients might require lifelong hemodialysis (HD) or peritoneal dialyses (PD). Due to the progression of dialysis, patients are likely to experience other chronic comorbidities, anxiety and depression, frequent hospitalizations, and higher rates of mortality compared to patients with other types of chronic illnesses. As a result, dialysis patients are prone to experience advance care planning (ACP) needs, such as whether they withdraw from receiving dialysis while approaching their end-of-life (EOL). Yet, existing studies have shown that dialysis patients seldom receive timely consultation regarding ACP and there are limited studies examining ACP amongst Taiwan HD patients. Purpose The purpose of this study was to examine ACP awareness, contemplation, self-efficacy and readiness; and factors influencing ACP readiness. Design This cross-sectional descriptive study with convenience sampling was conducted in the out-patient HD unit at a regional teaching hospital in southern Taiwan. A total of 143 ESRD patients undergoing HD treatments were recruited. A 55-item ACP engagement survey containing the subscales of awareness, contemplation, self-efficacy, and readiness was employed. The data were analyzed with t-tests, one-way ANOVAs, Pearson’s correlations and multiple regressions. Results The results of our investigation revealed that approximately half of the participants (n = 67, 46.9%) were not informed of ACP. Although they reported considering their EOL, medical decisions and desired care, they demonstrated significantly low self-efficacy in discussing ACP (t= -5.272, p < 0.001). HD duration influenced all four ACP subscales; religious beliefs significantly influenced ACP-self-efficacy and readiness; and marital status, education, and primary decision-maker status significantly influenced ACP-readiness. The predictors of ACP-readiness were high self-efficacy and being the primary decision-maker (Adjusted R2 61%). Conclusion Most of the HD patients in this study had low ACP-awareness, contemplation, self-efficacy, and readiness, and most had not completed any ACP-related advance directives (AD). Healthcare professionals should proactively provide HD patients with ACP-related information and answer patients’ and medical decision-makers’ questions in a timely manner, thereby improving the quality of EOL care.

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“…This is consistent with recent emphasis by experts in chronic illness, including kidney disease, on shared decision making and disease-specific advance care planning and research examining the effectiveness of interventions to support decision making for patients with advanced CKD. 30,31 Other priorities included interventions to improve care for patients who opt for conservative management, improve end-of-life care for patients with advanced CKD, and support informal caregivers. 21,[32][33][34] All studies have limitations.…”

Section: Discussionmentioning

confidence: 99%