School of Nursing, The Hong Kong Polytechnic University, Hong Kong.
Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong.
J Adv Nurs. 2019 Jun;75(6):1360-1369. doi: 10.1111/jan.13959. Epub 2019 Mar 5.
To examine the effect of a video-supported nurse-led advance care planning to frail geriatric patients on end-of-life decision-making outcomes in patients and their carers.
This is a double-blinded randomized controlled trial with parallel arms.
The protocol was approved by the Institutional Review Board of the participating hospital on 1 August 2018. Frail elders and their carer if any are enrolled during hospitalization, and undergo randomization after discharged. The intervention group receives a 2-week video-supported nurse-led advance care planning programme (N = 149) while the control group receives a 2-week health education program at home (N = 149). Follow-up surveys via telephone at 1 and 6 months measure outcomes regarding end-of-life decision-making from both the patients and the carers.
Advance care planning discussion is to understand patient's values, preferences and treatment for care on their anticipation of future deterioration. Treatment options for end-of-life care may not be well-received especially elders because in the discussion process, technical medical terms are presented in an abstract, hypothetical way that are hard to understand. The present study aims to evaluate the effect of a nurse-led advance care planning supplementing with a video showing end-of-life treatment options to promote end-of-life care decision-making among frail geriatric patients.
The results will help identify effective elements of advance care planning and inform the development of an evidence?based structured advance care planning intervention in response to the need for quality end-of-life care.
Chinese Clinical Trial Registry ChiCTR-IOR-17012341.
探讨视频支持的护士主导的预先护理计划对衰弱老年患者及其照顾者在临终决策结果方面的影响。
这是一项双盲随机对照试验,采用平行臂设计。
该方案于 2018 年 8 月 1 日获得参与医院的机构审查委员会批准。衰弱的老年人及其照顾者(如果有)在住院期间被招募,并在出院后进行随机分组。干预组接受为期 2 周的视频支持的护士主导的预先护理计划方案(N=149),而对照组在家中接受为期 2 周的健康教育计划(N=149)。通过电话在 1 个月和 6 个月进行随访调查,从患者和照顾者两个方面衡量临终决策的结果。
预先护理计划讨论是为了了解患者对未来恶化的预期的价值观、偏好和护理治疗。临终治疗选择可能不受欢迎,尤其是老年人,因为在讨论过程中,以抽象、假设的方式呈现技术医疗术语,难以理解。本研究旨在评估护士主导的预先护理计划补充视频展示临终治疗选择对促进衰弱老年患者临终护理决策的效果。
研究结果将有助于确定预先护理计划的有效要素,并为满足高质量临终关怀需求制定基于证据的结构化预先护理计划干预措施提供信息。
中国临床试验注册中心 ChiCTR-IOR-17012341。