Process and impact of an advance care planning intervention evaluated by bereaved surrogate decision-makers of dialysis patients

Song, Mi‐Kyung; Metzger, Maureen; Ward, Sandra E.

doi:10.1177/0269216316652012

Cited by 31 publications

(45 citation statements)

References 23 publications

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“…Prior studies conducted in patients with kidney disease and in other populations support the feasibility and effectiveness of engaging patients and families in advance care planning. 42 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 That a substantial proportion of participants herein who did not want to be resuscitated had documented neither a surrogate decision maker nor treatment preferences illuminates an important gap in care. A default approach to resuscitation in many health care systems makes these patients especially vulnerable to receiving care that is incongruent with their preferences.…”

Section: Discussionmentioning

confidence: 99%

Cardiopulmonary Resuscitation Preferences of People Receiving Dialysis

et al. 2020

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Section: Discussionmentioning

confidence: 99%

Cardiopulmonary Resuscitation Preferences of People Receiving Dialysis

et al. 2020

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“…17,56,57,66,67,73 ACP conversations had a positive influence on relationships with relatives and surrogate decision makers. 18,19,56,66,67,69,73…”

Section: Feasibility and Effectivenessmentioning

confidence: 99%

Interventions Guiding Advance Care Planning Conversations: A Systematic Review

Fahner

Beunders

Heide

et al. 2019

Journal of the American Medical Directors Association

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Background: Advance care planning (ACP) is a communicative process of defining preferences for future medical care. Conversation guides support professionals to conduct ACP conversations, yet insight into essential components is limited. Objectives: To evaluate the content, rationale, and empirical evidence on the effect of ACP interventions based on conversation guides. Methods: MEDLINE, Embase, PsycINFO, and CINAHL were searched from January 1, 1998, to February 23, 2018, to identify peer-reviewed articles describing or evaluating ACP interventions based on scripted conversation guides. A thematic analysis of the guides was performed. Data on intervention characteristics, underlying rationale, and empirical evidence were extracted by 2 authors independently using a predesigned form. Assessment of risk of bias and quality of reporting was performed using Cochrane tools and COREQ, respectively. Results: Eighty-two articles reporting on 34 unique interventions met the inclusion criteria. Analysis of the conversation guides revealed a framework for ACP conversations consisting of 4 phases: preparation, initiation, exploration, and action. Exploration of patient's perspectives on illness, living well, end-of-life (EOL) issues, and decision making formed the core part of the guides. Their design was often expertbased, without an underlying theoretical background. Empirical evidence on the effect of the interventions was based on heterogeneous outcome measures. Dyad congruence and preference documentation rates increased among intervention subjects in most studies. The studies showed varying effects on knowledge of ACP, decisional conflict, quality of communication, and preferences-concordant care. Qualitative research showed that participants appreciate the importance and benefits of ACP conversations, yet perceive them as difficult and emotional. Conclusion: ACP conversation guides address a diversity of themes regarding illness, EOL issues, and decision making. There is a focus on the exploration of patient's perspectives and preferences. Evidence on the translation of explorative information into specific treatment preferences and consequences for care as provided is limited.

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“…Persons with dementia often forward ACP decisions to their relatives while capacitated (17). Recent RCT study, which tested goals of care (GOC) decision video-aid intervention to improve quality of communication and palliative care for nursing homes residents with advanced dementia, reported improvement in GOC communication, enhanced GOC plans and reduced hospital transfers (18).…”

Section: What Are the Outcomes Of Acp And For Whom?mentioning

confidence: 99%

“…Relatives of nursing homes' residents are reporting to be insecure and their views of residents' ACP preferences significantly differ (26*). Two qualitative studies of bereaved surrogates' perspectives on ACP reveal that it facilitates important family discussions (27) and helps strengthening relationships (18). It also helps surrogates to better understand patient's illness and end-of-life care, to feel prepared for end-of-life decision-making, and to have peace of mind during and after decisionmaking (27,18).…”

Section: Acp Impact On Patients' Relativesmentioning

confidence: 99%

“…Two qualitative studies of bereaved surrogates' perspectives on ACP reveal that it facilitates important family discussions (27) and helps strengthening relationships (18). It also helps surrogates to better understand patient's illness and end-of-life care, to feel prepared for end-of-life decision-making, and to have peace of mind during and after decisionmaking (27,18). Providing quality information to the families and including them in continued communication during the evolving situation of advanced diseased is crucial for their collaboration in ACP decision-making (28*).…”

Section: Acp Impact On Patients' Relativesmentioning

confidence: 99%

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