Study protocol for Video Images about Decisions to Improve Ethical Outcomes with Palliative Care Educators (VIDEO-PCE): a pragmatic stepped wedge cluster randomised trial of older patients admitted to the hospital.
Study protocol for Video Images about Decisions to Improve Ethical Outcomes with Palliative Care Educators (VIDEO-PCE): a pragmatic stepped wedge cluster randomised trial of older patients admitted to the hospital.
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DOI：
10.1136/bmjopen-2022-065236
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发表时间：
2022-07-25
期刊：
影响因子：
2.9
通讯作者：
中科院分区：
文献类型：
--
作者：
尽管已知对患者和家属有好处，但在推进严重疾病的过程中，关于医疗保健的目标、价值和偏好的讨论往往不会发生。许多系统和临床医生的因素，如患者和临床医生沉默和专业姑息治疗团队的缺乏，导致了这种沟通的缺乏。为了解决这一差距，我们设计了一种干预措施，通过使用训练有素的姑息治疗教育者和视频决策辅助工具，在医院环境中促进护理目标对话和姑息治疗转诊。本文介绍了一项旨在解决65岁及以上住院成年人以及阿尔茨海默病和相关痴呆患者的护理目标对话障碍的试验的基本原理、设计和方法，无论年龄如何。姑息治疗教育者关于改善伦理结果的决策视频图像是一项务实的阶梯式群组随机对照试验，旨在改善和扩大医院环境中与接受过严重疾病沟通和视频决策辅助培训的姑息治疗教育者之间的护理目标对话。主要结果是电子健康记录中具有护理目标文档的患者的比例。我们估计将包括9000多名患者。波士顿医学中心的机构审查委员会(IRB)将作为本试验所有监管和伦理方面的单一IRB。BMC协议号：H-41482。调查结果将在国家会议和出版物上公布。这项试验在ClinicalTrials.gov上注册。NCT04857060；ClinicalTrials.gov
Despite the known benefit to patients and families, discussions about goals, values and preferences for medical care in advancing serious illness often do not occur. Many system and clinician factors, such as patient and clinician reticence and shortage of specialty palliative care teams, contribute to this lack of communication. To address this gap, we designed an intervention to promote goals-of-care conversations and palliative care referrals in the hospital setting by using trained palliative care educators and video decision aids. This paper presents the rationale, design and methods for a trial aimed at addressing barriers to goals-of-care conversations for hospitalised adults aged 65 and older and those with Alzheimer’s disease and related Dementias, regardless of age. The Video Image about Decisions to Improve Ethical Outcomes with Palliative Care Educators is a pragmatic stepped wedge, cluster randomised controlled trial, which aims to improve and extend goals-of-care conversations in the hospital setting with palliative care educators trained in serious illness communication and video decision aids. The primary outcome is the proportion of patients with goals-of-care documentation in the electronic health record. We estimate that over 9000 patients will be included. The Institutional Review Board (IRB) at Boston Medical Center will serve as the single IRB of record for all regulatory and ethical aspects of this trial. BMC Protocol Number: H-41482. Findings will be presented at national meetings and in publications. This trial is registered at ClinicalTrials.gov. NCT04857060; ClinicalTrials.gov
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DOI：
10.1111/j.1532-5415.2009.02304.x
发表时间：
2009-07-01
影响因子：
6.3
作者：
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通讯作者：
Mitchell, Susan L.
影响因子：
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作者：
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影响因子：
45.3
作者：
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通讯作者：
Volandes, Angelo E.
影响因子：
2.8
作者：
Lakin, Joshua R.;Benotti, Emily;Sanders, Justin
通讯作者：
Sanders, Justin
DOI：
10.1177/1049909116685046
发表时间：
2018-01-01
影响因子：
1.9
作者：
O'Mahony, Sean;Levine, Stacie;Deamant, Catherine
通讯作者：
Deamant, Catherine