Measuring engagement in advance care planning: a cross-sectional multicentre feasibility study.
Measuring engagement in advance care planning: a cross-sectional multicentre feasibility study.
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DOI：
10.1136/bmjopen-2015-010375
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发表时间：
2016-06-23
期刊：
影响因子：
2.9
通讯作者：
You JJ
中科院分区：
文献类型：
--
作者：
Howard M;Bonham AJ;Heyland DK;Sudore R;Fassbender K;Robinson CA;McKenzie M;Elston D;You JJ
评估一项新型调查（高级护理计划（ACP）参与度调查）在各种医疗保健环境中的可行性、可接受性和临床敏感性。来自初级保健、医院、癌症护理和透析护理机构的各50名患者的目标样本。一个方便的样本，没有认知障碍谁可以说和读英语的患者被招募。50岁及以上的患者有资格接受初级保健; 80岁及以上或55岁及以上的晚期慢性病临床标志物患者在医院招募; 19岁及以上的患者在癌症和肾透析中心招募。我们使用6分量表评估了ACP参与度调查的可行性、可接受性和临床敏感性。ACP参与调查采用5点Likert量表和行动（是/否）衡量ACP过程（知识，沉思，自我效能和准备）。196例患者（38-96岁，50.5%女性）参与研究。 平均（±SD）给药时间为48.8±19.6 min。 平均可接受性评分范围从医院的3.2±1.3到初级保健的4.7±0.9，平均相关性范围从医院的3.5±1.0到透析中心的4.9±0.9（两者均为p<0.001）。平均过程评分为3.1±0.6，平均行动评分为11.2±5.6（可能的25分）。ACP参与度调查证明了在门诊环境中的可行性和可接受性，但由于时间长度，在住院患者中的可行性和可接受性较差。较短的版本可能会提高可行性。非加太国家的参与程度为低至中等。
To assess the feasibility, acceptability and clinical sensibility of a novel survey, the advance care planning (ACP) Engagement Survey, in various healthcare settings. A target sample of 50 patients from each of primary care, hospital, cancer care and dialysis care settings. A convenience sample of patients without cognitive impairment who could speak and read English was recruited. Patients 50 and older were eligible in primary care; patients 80 and older or 55 and older with clinical markers of advanced chronic disease were recruited in hospital; patients aged 19 and older were recruited in cancer and renal dialysis centres. We assessed feasibility, acceptability and clinical sensibility of the ACP Engagement Survey using a 6-point scale. The ACP Engagement Survey measures ACP processes (knowledge, contemplation, self-efficacy and readiness) on 5-point Likert scales and actions (yes/no). 196 patients (38–96 years old, 50.5% women) participated. Mean (±SD) time to administer was 48.8±19.6 min. Mean acceptability scores ranged from 3.2±1.3 in hospital to 4.7±0.9 in primary care, and mean relevance ranged from 3.5±1.0 in hospital to 4.9±0.9 in dialysis centres (p<0.001 for both). The mean process score was 3.1±0.6 and the mean action score was 11.2±5.6 (of a possible 25). The ACP Engagement Survey demonstrated feasibility and acceptability in outpatient settings but was less feasible and acceptable among hospitalised patients due to length. A shorter version may improve feasibility. Engagement in ACP was low to moderate.