Ampe Sophie, Sevenants Aline, Coppens Evelien, Spruytte Nele, Smets Tinne, Declercq Anja, van Audenhove Chantal
KU Leuven, LUCAS, Centre for Care Research and Consultancy, Belgium.
J Adv Nurs. 2015 May;71(5):1156-68. doi: 10.1111/jan.12601. Epub 2014 Dec 23.
To evaluate the effects of 'we DECide', an educational intervention for nursing home staff on shared decision-making in the context of advance care planning for residents with dementia.
Advance care planning (preparing care choices for when persons no longer have decision-making capacity) is of utmost importance for nursing home residents with dementia, but is mostly not realized for this group. Advance care planning consists of discussing care choices and making decisions and corresponds to shared decision-making (the involvement of persons and their families in care and treatment decisions).
This quasi-experimental pre-test-post-test study is conducted in 19 nursing homes (Belgium). Participants are nursing home staff.
'We DECide' focuses on three crucial moments for discussing advance care planning: the time of admission, crisis situations and everyday conversations. The 'ACP-audit' assesses participants' views on the organization of advance care planning (organizational level), the 'OPTION scale' evaluates the degree of shared decision-making in individual conversations (clinical level) and the 'IFC-SDM Questionnaire' assesses participants' views on Importance, Frequency and Competence of realizing shared decision-making (clinical level). (Project funded: July 2010).
The study hypothesis is that 'we DECide' results in a higher realization of shared decision-making in individual conversations on advance care planning. A better implementation of advance care planning will lead to a higher quality of end-of-life care and more person-centred care. We believe our study will be of interest to researchers and to professional nursing home caregivers and policy-makers.
评估“我们做决定”这一针对养老院工作人员的教育干预措施，在为痴呆症患者进行预先护理计划的背景下，对共同决策的影响。
预先护理计划（为个人失去决策能力时准备护理选择）对患有痴呆症的养老院居民至关重要，但该群体大多未能实现。预先护理计划包括讨论护理选择和做出决定，这与共同决策（个人及其家人参与护理和治疗决策）相对应。
这项准实验性的前后测研究在19家养老院（比利时）进行。参与者为养老院工作人员。
“我们做决定”聚焦于讨论预先护理计划的三个关键时刻：入院时、危机情况和日常对话。“预先护理计划审计”评估参与者对预先护理计划组织的看法（组织层面），“OPTION量表”评估个体对话中共同决策的程度（临床层面），“IFC - 共同决策问卷”评估参与者对实现共同决策的重要性、频率和能力的看法（临床层面）。（项目资助：2010年7月）
研究假设是“我们做决定”会使在关于预先护理计划的个体对话中更高程度地实现共同决策。更好地实施预先护理计划将带来更高质量的临终护理和更以人为本的护理。我们相信我们的研究将引起研究人员、专业养老院护理人员和政策制定者的兴趣。
