Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Advance Care Planning Australia, Austin Health, Heidelberg, Victoria, Australia.
BMJ Open. 2017 Nov 3;7(11):e018024. doi: 10.1136/bmjopen-2017-018024.
Advance care planning (ACP) is a process between a person, their family/carer(s) and healthcare providers that supports adults at any age or stage of health in understanding and sharing their personal values, life goals and preferences regarding future medical care. The Australian government funds a number of national initiatives aimed at increasing ACP uptake; however, there is currently no standardised Australian data on formal ACP documentation or self-reported uptake. This makes it difficult to evaluate the impact of ACP initiatives. This study aims to determine the Australian national prevalence of ACP and completion of Advance Care Directives (ACDs) in hospitals, aged care facilities and general practices. It will also explore people's self-reported use of ACP and views about the process.
Researchers will conduct a national multicentre cross-sectional prevalence study, consisting of a record audit and surveys of people aged 65 years or more in three sectors. From 49 participating Australian organisations, 50 records will be audited (total of 2450 records). People whose records were audited, who speak English and have a decision-making capacity will also be invited to complete a survey. The primary outcome measure will be the number of people who have formal or informal ACP documentation that can be located in records within 15 min. Other outcomes will include demographics, measure of illness and functional capacity, details of ACP documentation (including type of document), location of documentation in the person's records and whether current clinical care plans are consistent with ACP documentation. People will be surveyed, to measure self-reported interest, uptake and use of ACP/ACDs, and self-reported quality of life.
This protocol has been approved by the Austin Health Human Research Ethics Committee (reference HREC/17/Austin/83). Results will be submitted to international peer-reviewed journals and presented at international conferences.
ACTRN12617000743369.
预先医疗照护计划（ACP）是一个在个人、其家属/照护者和医疗保健提供者之间进行的过程，旨在帮助任何年龄或健康阶段的成年人了解和分享他们对未来医疗护理的个人价值观、生活目标和偏好。澳大利亚政府资助了多项旨在提高 ACP 参与度的国家计划；然而，目前澳大利亚没有关于正式 ACP 文件记录或自我报告的参与度的标准化数据。这使得评估 ACP 计划的影响变得困难。本研究旨在确定澳大利亚医院、养老院和全科医生诊所中 ACP 的全国流行率以及预先医疗指示（ACDs）的完成情况。它还将探讨人们对 ACP 的自我报告使用情况和对该过程的看法。
研究人员将进行一项全国性的多中心横断面流行率研究，包括对三个领域的 65 岁及以上人群的记录审核和调查。从 49 个参与的澳大利亚组织中，将审核 50 个记录（共 2450 个记录）。对审核记录的人，只要他们会说英语且有决策能力，也将被邀请完成一项调查。主要的结果衡量标准将是能够在 15 分钟内找到记录中正式或非正式 ACP 文件记录的人数。其他结果将包括人口统计学、疾病和功能能力的衡量标准、ACP 文件记录的详细信息（包括文件类型）、文件记录中文件的位置以及当前的临床护理计划是否与 ACP 文件记录一致。将对人们进行调查，以衡量自我报告的 ACP/ACDs 兴趣、参与度和使用情况以及自我报告的生活质量。
本方案已获得奥辛健康人体伦理委员会（参考 HREC/17/Austin/83）的批准。结果将提交给国际同行评议期刊，并在国际会议上发表。
ACTRN12617000743369。
