High satisfaction and low decisional conflict with advance care planning among chronically ill patients with advanced chronic obstructive pulmonary disease or heart failure using an online decision aid: A pilot study
High satisfaction and low decisional conflict with advance care planning among chronically ill patients with advanced chronic obstructive pulmonary disease or heart failure using an online decision aid: A pilot study
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DOI：
10.1177/1742395316633511
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发表时间：
2016-09-01
期刊：
影响因子：
1.3
通讯作者：
Levi, Benjamin H.
中科院分区：
文献类型：
--
作者：
Van Scoy, Lauren J.;Green, Michael J.;Levi, Benjamin H.
目的：许多慢性病患者表示希望更多地参与医疗决策。这项试点研究旨在探讨患有晚期心力衰竭或慢性阻塞性肺病等易加重疾病轨迹的患者如何使用在线决策辅助来体验预先护理计划，并比较不同类型的易加重疾病的患者使用该工具是否有不同的经历。方法：干预前问卷测量预先护理计划知识。干预后问卷测量：（1）预先护理计划知识； (2) 对工具的满意度； （三）决策冲突； (4) 预先医疗指示的准确性。对心力衰竭和慢性阻塞性肺疾病患者进行了比较。结果：超过 90% 的心力衰竭 (n = 24) 或慢性阻塞性肺疾病 (n = 25) 患者在所有满意度领域对该工具表示“满意”或“高度满意”；超过 90% 的参与者将最终的预先指示评为“非常准确”。参与者表示决策冲突很少。预先护理计划知识得分上升了 18%（p
Objective: Many patients with chronic illnesses report a desire for increased involvement in medical decision-making. This pilot study aimed to explore how patients with exacerbation-prone disease trajectories such as advanced heart failure or chronic obstructive pulmonary disease experience advance care planning using an online decision aid and to compare whether patients with different types of exacerbation-prone illnesses had varied experiences using the tool.Methods: Pre-intervention questionnaires measured advance care planning knowledge. Post-intervention questionnaires measured: (1) advance care planning knowledge; (2) satisfaction with tool; (3) decisional conflict; and (4) accuracy of the resultant advance directive. Comparisons were made between patients with heart failure and chronic obstructive pulmonary disease.Results: Over 90% of the patients with heart failure (n = 24) or chronic obstructive pulmonary disease (n = 25) reported being "satisfied'' or "highly satisfied'' with the tool across all satisfaction domains; over 90% of participants rated the resultant advance directive as "very accurate.'' Participants reported low decisional conflict. Advance care planning knowledge scores rose by 18% (p