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A quasi-experimental evaluation of advance care planning improves consistency between elderly individuals and their surrogates regarding end-of-life care preferences: Development and application of a decision aid with cartoon pictures
Authors:Li-Shan Ke  Wen-Yu Hu  Ching-Yu Chen  Chieh-Yu Liu  Tai-Yuan Chiu
Affiliation:1. National Taipei University of Nursing and Health Sciences, School of Nursing, Taipei, Taiwan;2. Taipei Veterans General Hospital, Department of Nursing, Taipei, Taiwan;3. National Taiwan University, College of Medicine, School of Nursing, Taipei, Taiwan;4. National Taiwan University Hospital, Department of Nursing, Taipei, Taiwan;5. National Taiwan University, College of Medicine, Taipei, Taiwan;6. National Taiwan University Hospital, Department of Family Medicine, Taipei, Taiwan;7. National Taipei University of Nursing and Health Sciences, Department of Speech Language Pathology and Audiology, Taipei, Taiwan;1. Department of Community Health Sciences, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada;2. Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Sherbrooke, QC, Canada;3. Department of Family Medicine, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada;1. School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan;2. Department of Psychiatry, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan;3. Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan;4. Department of Psychiatry, Chang Gung Memorial Hospital, Keelung, Taiwan;5. Department of Medicine, Chang Gung University, Tao-Yuan, Taiwan;1. Rory Meyers College of Nursing, New York University, New York, NY;2. Department of Sociology, University of Hawai''i at Mānoa, Mānoa, HI;1. Department of Nursing, Buddhist Tzu Chi General Hospital, Hualien, Taiwan;2. School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan;3. Department of Nursing, Tzu Chi University, Hualien, Taiwan;4. Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan;5. Department of Family Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan;6. Department of Medicine, Tzu Chi University, Hualien, Taiwan;7. Department of Nursing, Tzu Chi College of Technology, Hualien, Taiwan;1. The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong;2. Haven of Hope Hospital, Hong Kong;3. School of Nursing, The Hong Kong Polytechnic University, Hong Kong
Abstract:
ObjectiveThis study sought to develop a decision aid with cartoon pictures and evaluate its effectiveness in increasing consistency between elderly individuals and their surrogates regarding end-of-life care.MethodsA pre-post quasi-experimental design was adopted using the Life Support Preferences Questionnaire. The intervention had two components: (1) increasing participants’ knowledge of medical treatments related to end-of-life care, and (2) sharing their end-of-life wishes. The experimental group received an intervention, whereas the control group received usual care.ResultsA total of 110 participants in 55 pairs of elderly individuals with average aged 86.4 and their surrogates (27 in the experimental group, 28 in the control group) were recruited from a veterans hospital in northern Taiwan. Nearly 90 % of elderly individuals were male. The multiple linear regression showed that the inconsistent gap between elderly individuals and their surrogates in the experimental group decreased 12 points than the control group after controlling the covariances (B = ?12.116, p = 0.032).ConclusionThe intervention improved the consistency between elderly individuals and their surrogates regarding end-of-life care.Practice implicationsA decision aid with cartoon pictures may support the discussion of end-of-life care in older Asian populations.
Keywords:Elderly individuals  Older people  Surrogates  End-of-life care  Preferences  Advance care planning  Advance directives  Advance decisions
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