Young Adults’ Perspectives on Advance Care Planning

Tripken, Jennifer; Elrod, Cathy S.

doi:10.1177/1049909117727456

Cited by 25 publications

(30 citation statements)

References 21 publications

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“…During a recent qualitative advance care planning patient portal study, older patients and their caregivers indicated a need for easy access to their current active MDPOA via the portal [ 29 ]. Access to the MDPOA enables ongoing review and updating of patient preferences, which are important aspects of advance care planning as an ongoing process [ 4 , 30 , 31 ]. Patients did use the advance care planning message tool, albeit less frequently; over half of the messages during the study period were sent in the month of April.…”

Section: Discussionmentioning

confidence: 99%

“…Lack of advance care planning awareness and perception among healthy young adults that advance care planning is unnecessary are two major barriers to their involvement in advance care planning. However, young adults who have previous experiences with a seriously ill loved one have demonstrated increased advance care planning awareness and preference for completing an advance directive [ 30 , 31 ]. Contextually, at the end of May 2020, approximately 33% of Coloradans diagnosed with COVID-19 were aged 20 to 39 years (approximately 8728 individuals, as reported on June 6, 2020), and 6.6% of these cases resulted in hospitalization [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…Gender differences have been found in both patient portal use and advance care planning, with women being more likely to engage with a portal [ 36 ] and with advance care planning [ 25 , 32 , 33 ]. Even among young adults, a national survey found that male respondents reported less familiarity with the concepts of advance care planning, advance directives, and health care proxies [ 30 ]. In Colorado, approximately 48% of patients with COVID-19 are male; however, male patients represent 56% of COVID-19 deaths [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

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Advance Care Planning Among Users of a Patient Portal During the COVID-19 Pandemic: Retrospective Observational Study

Portz¹,

Brungardt²,

Shanbhag³

et al. 2020

J Med Internet Res

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Background Advance care planning is the process of discussing health care treatment preferences based on patients’ personal values, and it often involves the completion of advance directives. In the first months of 2020, a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), began circulating widely in the American state of Colorado, leading to widespread diagnosis of coronavirus disease (COVID-19), hospitalizations, and deaths. In this context, the importance of technology-based, non–face-to-face methods to conduct advance care planning via patient portals has increased. Objective The aim of this study was to determine the rates of use of a web-based advance care planning tool through a health system–based electronic patient portal both before and in the early months of the COVID-19 pandemic. Methods In 2017, we implemented web-based tools through the patient portal of UCHealth’s electronic health record (EHR) for patients to learn about advance care planning and complete an electronically signed medical durable power of attorney (MDPOA) to legally appoint a medical decision maker. Patients accessing the portal can complete and submit a legally valid MDPOA, which becomes part of their medical record. We collected data on the patients’ date of MDPOA completion, use of advance care planning messaging, age, sex, and geographic location during the early phase of the COVID-19 pandemic (December 29, 2019, to May 30, 2020). Results Over a 5-month period that includes the early phase of the COVID-19 pandemic in Colorado, total monthly use of the advance care planning portal tool increased from 418 users in January to 1037 users in April and then decreased slightly to 815 users in May. The number of MDPOA forms submitted per week increased 2.4-fold after the stay-at-home order was issued in Colorado on March 26, 2020 (P<.001). The mean age of the advance care planning portal users was 47.7 years (SD 16.1), and 2206/3292 (67.0%) were female. Women were more likely than men to complete an MDPOA, particularly in younger age groups (P<.001). The primary use of the advance care planning portal tools was the completion of an MDPOA (3138/3292, 95.3%), compared to sending an electronic message (148/3292, 4.5%). Over 50% of patients who completed an MDPOA did not have a prior agent in the EHR. Conclusions Use of a web-based patient portal to complete an MDPOA increased substantially during the first months of the COVID-19 pandemic in Colorado. There was an increase in advance care planning that corresponded with state government shelter-in-place orders as well as public health reports of increased numbers of COVID-19 cases and deaths. Patient portals are an important tool for providing advance care planning resources and documenting medical decision makers during the pandemic to ensure that medical treatment aligns with patient goals and values.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Advance Care Planning Among Users of a Patient Portal During the COVID-19 Pandemic: Retrospective Observational Study

Portz¹,

Brungardt²,

Shanbhag³

et al. 2020

J Med Internet Res

View full text Add to dashboard Cite

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“…Since the 13th Five-Year Plan for Healthy Aging that emphasized satisfy the needs of the end-of-life patients had been issued by the National Health Commission in 2017, ACP has received unprecedented attention in mainland China [13]. University students, as the future backbone of the society, may play important roles in initiating and facilitating end-of-life discussions and be instrumental in ACP for their elders [14]. Although the great awareness and positive attitudes regarding ACP among university students will promote the spread and the development of ACP in public [15], there is a paucity of information on their awareness and attitudes towards ACP in mainland China.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Awareness and Attitudes Toward Advance Care Planning Between Chinese Medical and Non-medical University Students

Liu¹,

Meng²,

Sun³

et al. 2021

Preprint

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Background: To date, there is a paucity of information on the discrepancies of awareness and attitudes towards ACP among university students in mainland China. The purposes of this study are to investigate the discrepancies in the awareness and attitudes toward advance care planning (ACP) between Chinese medical and non-medical university students and to identify the association between the awareness and attitudes toward ACP and medical education. A total of 718 university students included 290 medical students and 428 non-medical students from 12 universities in 4 provinces in mainland China were surveyed by using the Advance Care Planning Questionnaire (ACPQ). Results: More than half of the university students (59.89%) had never heard of ACP before; there were significant differences in the awareness regarding ACP between medical students and their non-medical peers (P<0.05); 82.45% of participants were more likely to consider discussing ACP in the future; there was no significant difference (P>0.05) in the previous experience last 5 years between the two groups except the item of “have been involved in the decision making of your treatment” (P=0.005); univariate analysis and multivariate linear regression analysis showed that medical education was the factor influencing the awareness of end-of-life (P=0.000) and proxy decision-maker (P=0.028) among university students. Conclusion: The awareness toward ACP of university students in mainland China remained limited, but their attitudes were positive. Medical students had a higher level of awareness regarding ACP than non-medical students, and medical education was the factor that promoted students to understand end-of-life care and proxy decision-maker. Establishing educational initiatives, developing models for peer-led ACP, and perfecting governmental policies should be emphasized.

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“…For example, medical literature indicates that young adults, who may become caregivers for aging family members, and adolescent oncology patients in particular need to be engaged in advance care planning. [2][3][4] However, whenever physicians approach the topic of EOL care, they "should be sensitive to each patient's individual situations and preferences," considering the various factors that might affect patients' decision making, such as "culture, faith traditions, and life experience." 1 Opinion 5.2, "Advance Directives," 5 discusses the importance of documenting advance care planning discussions.…”

mentioning

confidence: 99%

AMA Code of Medical Ethics' Opinions Related to End-of-Life Care

2018

AMA Journal of Ethics

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Young Adults’ Perspectives on Advance Care Planning

Cited by 25 publications

References 21 publications

Advance Care Planning Among Users of a Patient Portal During the COVID-19 Pandemic: Retrospective Observational Study

Advance Care Planning Among Users of a Patient Portal During the COVID-19 Pandemic: Retrospective Observational Study

Comparison of Awareness and Attitudes Toward Advance Care Planning Between Chinese Medical and Non-medical University Students

AMA Code of Medical Ethics' Opinions Related to End-of-Life Care

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