Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan.
Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Geriatr Gerontol Int. 2021 Jun;21(6):478-484. doi: 10.1111/ggi.14158. Epub 2021 Apr 16.
This study aimed to develop a video-based advance care planning intervention, and examine the effectiveness of the intervention on knowledge, behavioral intentions and advance directive signing among older patients admitted to a geriatric unit in Taiwan.
This randomized controlled trial was carried out in two geriatric wards of a medical center in northern Taiwan, between June 2014 and June 2015. The participants were randomly assigned to the intervention (n = 39) or control (n = 43) group. Participants in the intervention group watched a 5-min video regarding advance care planning. The control group received usual care. Structured questionnaires on advance care planning knowledge and behavioral intentions were administered to both groups before and after the intervention. Advance directive signing was carried out until 2 weeks after hospital discharge through a chart review.
The intervention group showed a significantly higher advance care planning knowledge score and behavioral intention score than the control group post-intervention. The rate of advance directive signing was 33.3% in the intervention group and 9.3% in the control group (P = 0.01).
This study showed the effectiveness of video-based interventions in increasing advance care planning knowledge, behavioral intention and advance directive signing among hospitalized older patients. Geriatric wards could use our model to promote advance care planning among older patients. Geriatr Gerontol Int 2021; 21: 478-484.
本研究旨在开发一种基于视频的预先医疗照护计划干预措施，并考察其在提高知识水平、增强行为意向和签署预先医疗指示方面对台湾某老年科住院患者的有效性。
本随机对照试验于 2014 年 6 月至 2015 年 6 月在台湾某医学中心的两个老年病房进行。将参与者随机分配至干预组（n=39）或对照组（n=43）。干预组观看时长 5 分钟的关于预先医疗照护计划的视频，对照组接受常规护理。两组在干预前后均接受关于预先医疗照护计划知识和行为意向的结构化问卷调查。通过病历查阅，在出院后 2 周内完成预先医疗指示的签署。
干预组在干预后显示出更高的预先医疗照护计划知识评分和行为意向评分，显著高于对照组。干预组的预先医疗指示签署率为 33.3%，对照组为 9.3%（P=0.01）。
本研究表明，基于视频的干预措施可有效提高住院老年患者的预先医疗照护计划知识水平、行为意向和预先医疗指示签署率。老年病房可采用我们的模式促进老年患者的预先医疗照护计划。国际老年医学和老年学杂志 2021;21:478-484.
