The value history: A necessary family document

Justin, Renate G.

doi:10.1007/bf00489463

Cited by 9 publications

(5 citation statements)

References 4 publications

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“…Second, although some generic values history tools have been previously developed, they have limitations. For instance, in the late 1980s and early 1990s, Justin,11 Lambert et al ,12 and Doukas and McCullough13 each described their own values history tools intended to inform future decisions about life-sustaining treatments. Although similar in nature to the Short GVHT, the development of these tools was not well described and none of these tools were evaluated for their validity in supporting communication or decision making during serious illness.…”

Section: Discussionmentioning

confidence: 99%

“…Although some generic values history tools do exist, their development is not well described, they are not validated, or they may be too difficult or complex to be used by individuals with lower literacy or lower health literacy. [11][12][13] Recently, to address these limitations, the Graphic Values History Tool (GVHT) was developed to be an easy to use, disease-agnostic tool to support Research better ACP between patients and substitute decision makers. Based on end-user feedback from patients and laypersons during its development, the GVHT includes graphic elements to increase clarity, including images to portray different health states.…”

Section: Introductionmentioning

confidence: 99%

“…In contrast, the purpose of ACP and goals-of-care discussions is to inform a wide array of future decisions in the context of any serious life-limiting illness. Although some generic values history tools do exist, their development is not well described, they are not validated, or they may be too difficult or complex to be used by individuals with lower literacy or lower health literacy 11–13. Recently, to address these limitations, the Graphic Values History Tool (GVHT) was developed to be an easy to use, disease-agnostic tool to support better ACP between patients and substitute decision makers.…”

Section: Introductionmentioning

confidence: 99%

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Short Graphic Values History Tool for decision making during serious illness

You

Allatt

Howard

et al. 2019

BMJ Support Palliat Care

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ObjectivesTo develop and validate a values clarification tool, the Short Graphic Values History Tool (GVHT), designed to support person-centred decision making during serious illness.MethodsThe development phase included input from experts and laypersons and assessed acceptability with patients/family members. In the validation phase, we recruited additional participants into a before–after study. Our primary validation hypothesis was that the tool would reduce scores on the Decisional Conflict Scale (DCS) at 1–2 weeks of follow-up. Our secondary validation hypotheses were that the tool would improve values clarity (reduce scores) more than other DCS subscales and increase engagement in advance care planning (ACP) processes related to identification and discussion of one’s values.ResultsIn the development phase, the tool received positive overall ratings from 22 patients/family members in hospital (mean score 4.3; 1=very poor; 5=very good) and family practice (mean score 4.5) settings. In the validation phase, we enrolled 157 patients (mean age 71.8 years) from family practice, cancer clinic and hospital settings. After tool completion, decisional conflict decreased (−6.7 points, 95% CI −11.1 to −2.3, p=0.003; 0–100 scale; N=100), with the most improvement seen in the values clarity subscale (−10.0 points, 95% CI −17.3 to −2.7, p=0.008; N=100), and the ACP-Values process score increased (+0.4 points, 95% CI 0.2 to 0.6, p=0.001; 1–5 scale; N=61).ConclusionsThe Short GVHT is acceptable to end users and has some measure of validity. Further study to evaluate its impact on decision making during serious illness is warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Short Graphic Values History Tool for decision making during serious illness

You

Allatt

Howard

et al. 2019

BMJ Support Palliat Care

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“…The GVHT addresses some of the limitations of previously developed values history tools. [13][14][15][16][17][18] First, earlier tools were best suited to individuals with greater health literacy. To develop the GVHT, we obtained input from people with diverse educational and occupational backgrounds, including those with lower health literacy, to maximize its clarity in terms of both content and format.…”

Section: Discussionmentioning

confidence: 99%

Development and Pilot Testing of a Novel Graphic Values History Tool to Support Communication and Decision Making During Serious Illness

Allatt¹,

You²

2019

Can Journ Gen Int Med

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Background: We report the development and pilot-testing of a values history tool to support patients and their substitute decision makers (SDMs) in advance care planning.Methods: Tool development was an iterative, multi-phase process involving expert input, literature review, patient input, and beta-testing with 35 laypersons. In a single-center, before-after pilot study, we assessed the acceptability, clarity, and potential utility of the tool. Results: Participants (n=6; 3 patients and 3 SDMs) rated the tool as clear (4.7/5), worthwhile (4.7/5), and said it did not cause distress (4.7/5).Tool completion and discussion resulted in better understanding of patient values (mean 4.5 on a 5-point scale) and helped build understanding between patient and SDM (4.3/5). ParticipantsConclusions: Based on development involving content experts, patients, and laypersons, we conclude that our tool has face and content validity. Our pilot study suggests it merits evaluation in larger studies to further evaluate its utility.

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“…Though she had married a physician, she resented a medical establishment that seemed unable to listen to her and help her to achieve her goal. The case of Peggy Sue L. Balducci (&) Editor-in-Chief, Moffitt Cancer Center, Tampa, FL, USA e-mail: lodovico.balducci@moffitt.org underlines the importance of obtaining a ''value history'' [6] from a patient whose management may include death and life decisions. Originally, the value history was intended as an instrument to facilitate end-of-life decisions and to avoid a conflict between patient and physician values (the right of a patient to know where a physician stands in terms of abortion and euthanasia, for example).…”

mentioning

confidence: 99%

Value, the new medical mantra: misunderstood, abused, and underused

Balducci

2013

J Med Pers

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The value history: A necessary family document

Cited by 9 publications

References 4 publications

Short Graphic Values History Tool for decision making during serious illness

Short Graphic Values History Tool for decision making during serious illness

Development and Pilot Testing of a Novel Graphic Values History Tool to Support Communication and Decision Making During Serious Illness

Value, the new medical mantra: misunderstood, abused, and underused

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