Department of Psychology, 5631West Virginia University, Morgantown, WV, USA.
Department of Medicine, 24041West Virginia University School of Medicine, Morgantown, WV, USA.
J Palliat Care. 2020 Oct;35(4):243-247. doi: 10.1177/0825859720923437. Epub 2020 May 6.
BACKGROUND/OBJECTIVES: Physician Orders for Life-Sustaining Treatment (POLST) is recommended as a preferred practice for advance care planning with seriously ill patients. Decision aids can assist patients in advance care planning, but there are limited studies on their use for POLST decisions. We hypothesized that after viewing a POLST video, decision aid participants would demonstrate increased knowledge and satisfaction and decreased decisional conflict.
Pre-and postintervention with no control group.
SETTING/PARTICIPANTS: Fifty community-dwelling adults aged 65 and older asked to complete a POLST based on a hypothetical condition.
Video decision aid for Sections A and B of the POLST form.
Pre- and postintervention participant knowledge, decisional satisfaction, decisional conflict, and acceptability of video decision aid.
Use of the video decision aid increased knowledge scores from 11.24 ± 2.77 to 14.32 ± 2.89, < .001, improved decisional satisfaction 10.14 ± 3.73 to 8.70 ± 3.00, = .001, and decreased decisional conflict 12 ± 9.42 to 8.15 ± 9.13, < .001. All participants reported that they were comfortable using the video decision aid, that they would recommend it to others, and that it clarified POLST decisions.
Participants endorsed the use of a POLST video decision aid, which increased their knowledge of POLST form options and satisfaction with their decisions, and decreased their decisional conflict in POLST completion. This pilot study provides preliminary support for the use of video decision aids for POLST decision-making. Future research should evaluate a decision aid for the entire POLST form and identify patient preferences for implementing POLST decision aids into clinical practice.
背景/目的：医师实施的维持生命治疗医嘱（POLST）被推荐作为与重病患者进行预先护理计划的首选实践。决策辅助工具可以帮助患者进行预先护理计划，但关于其在 POLST 决策中的使用的研究有限。我们假设，在观看 POLST 视频后，决策辅助工具的参与者将表现出更高的知识和满意度，以及更低的决策冲突。
前后干预，无对照组。
地点/参与者：50 名居住在社区的 65 岁及以上的成年人，根据假设情况被要求完成 POLST。
POLST 表格 A 和 B 部分的视频决策辅助工具。
干预前后参与者的知识、决策满意度、决策冲突和对视频决策辅助工具的可接受性。
使用视频决策辅助工具使知识得分从 11.24 ± 2.77 提高到 14.32 ± 2.89， <.001，提高决策满意度 10.14 ± 3.73 到 8.70 ± 3.00， =.001，降低决策冲突 12 ± 9.42 到 8.15 ± 9.13， <.001。所有参与者都表示他们使用视频决策辅助工具感到舒适，他们会向他人推荐，并认为它澄清了 POLST 决策。
参与者认可使用 POLST 视频决策辅助工具，这提高了他们对 POLST 表格选项的了解和对决策的满意度，并降低了他们在完成 POLST 时的决策冲突。这项试点研究为使用视频决策辅助工具进行 POLST 决策提供了初步支持。未来的研究应该评估整个 POLST 表格的决策辅助工具，并确定患者对将 POLST 决策辅助工具纳入临床实践的偏好。
