Promoting advance care planning among community-based older adults: A randomized controlled trial
Promoting advance care planning among community-based older adults: A randomized controlled trial
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DOI：
10.1016/j.pec.2016.05.009
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发表时间：
2016-11-01
影响因子：
3.5
通讯作者：
Bellemare, Suzanne
中科院分区：
文献类型：
--
作者：
Bravo, Gina;Trottier, Lise;Bellemare, Suzanne
目的：为了测试的干预措施，旨在激励老年人在记录他们的医疗保健偏好提前，并指导代理人在作出假设的决定相匹配的老年adult.Methods：该试验涉及235名老年人，其中一半是协助沟通他们的愿望，他们的代理。假设的小插曲，在基线和两次干预后，引起老年人的喜好和评估他们的代理人的能力，以预测them.Results：到试验结束时，80%的老年人分配到实验组记录了他们的愿望。随着时间的推移，平均准确性分数的变化并没有不同的任何假设的情况下，除了当限制样本的二人组是高度不一致的basel.Conclusion：干预动机的老年人表达自己的喜好，但代理人的能力预测他们的影响不大。为这项研究开发的教育工具将帮助医疗保健提供者帮助老年人提前记录他们的愿望。必须告知客户作出替代决定的挑战，以及需要讨论代理人在解释所表达的意愿时应有多少回旋余地。(C)2016作者（S）出版社：Elsevier爱尔兰Ltd.
Objective: To test an intervention designed to motivate older adults in documenting their healthcare preferences in advance, and to guide proxies in making hypothetical decisions that match those of the older adult.Methods: The trial involved 235 older adults, of which half were assisted in communicating their wishes to their proxy. Hypothetical vignettes were used at baseline and twice after the intervention to elicit older adults' preferences and assess their proxy's ability to predict them.Results: By the end of the trial, 80% of older adults allocated to the experimental group had documented their wishes. Changes over time in mean accuracy scores did not differ between groups for any hypothetical situations, except when limiting the sample to dyads that were highly discordant at baseline.Conclusion: The intervention motivated a large proportion of older adults to express their preferences but had little effect on proxies' ability to predict them.Practice implications: Educational tools developed for this study will assist healthcare providers in helping older adults to record their wishes in advance. Clients must be informed of the challenge of making substitute decisions and of the need to discuss the amount of leeway the proxy should have in interpreting expressed wishes. (C) 2016 The Author(s). Published by Elsevier Ireland Ltd.