Improving End-of-Life Care for Cancer Patients with Video Decision Aids

利用视频决策辅助改善癌症患者的临终护理

• 批准号: 8628060
• 负责人: Angelo Volandes
• 金额: $ 11.51万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-03-01 至 2014-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8628060
• 关键词: Improving; End; Life; Care; Cancer

DESCRIPTION (provided by applicant): Advance Care Planning (ACP) is the process by which patients plan for future medical care in the event of impaired decision making. Informed ACP can be a complex process. It is very difficult to realistically envision future care solely with verbal or written descriptions. Video is an under utilized medium that can enhance verbal and written approaches to ACP by providing realistic and easily understandable visual images of care to improve understanding and communication between patients and physicians. The projects proposed in this application focus on the use of video decision aids to improve the ACP process for older persons with advanced cancer. Dr. Volandes proposes the following three projects: 1. to develop a video decision aid of the goals of care for advanced cancer; 2. to conduct a randomized trial of the goals of care video decision aid (vs. a verbal narrative) to demonstrate its ability to improve the ACP process among 210 patients aged 65 or older with advanced cancer and to compare patients' end of life preferences, as reflected in their choice of the primary goal of care, between the video and verbal narrative groups; and, 3. To study the implementation of the video decision aid in clinical practice among 50 oncologists. Through coursework, seminars, and the development and completion of the proposed research, Dr. Volandes plans to enhance his methodological skills and understanding of health services research; develop expertise in end of life decision making and ACP; and, collect data on the use of video decision aids to promote the delivery of high quality, preference sensitive end of life care for older persons. In the future, Dr. Volandes plans to use the skills he obtains to explore the use of video decision aids for older persons with other diseases. Receipt of a K08 career development award will provide the optimal pathway for Dr. Volandes to acquire additional research skills and expertise in decision making for the elderly with cancer. This award will also further his long term career goal to become a skilled and established independent investigator in the area of end-of-life decision making and communication. Treatment decisions at the end of life for cancer patients are some of the most difficult decisions confronting medicine. Both physicians and the public have shown a heightened interest in advance care planning to help clinical decision-making. Our study explores the use of video decision aids in assisting discussions between older patients with advanced cancer and their physicians. The present work of using video decision aids in end-of-life discussions in the context of cancer will serve as a prototype for other common diseases that involve difficult decisions.

描述（由申请人提供）：预先护理计划（ACP）是患者在决策受损的情况下计划未来医疗护理的过程。知情ACP可能是一个复杂的过程。仅凭口头或书面描述，很难现实地设想未来的护理。视频是一种未被充分利用的媒介，它可以通过提供真实和易于理解的视觉图像来改善患者和医生之间的理解和沟通，从而增强ACP的口头和书面方法。本申请中提出的项目侧重于使用视频决策辅助工具来改善晚期癌症老年人的ACP程序。Volandes博士提出以下三个项目：开发晚期癌症护理目标的视频决策辅助工具；2. 对护理视频决策辅助（与口头叙述）的目标进行随机试验，以证明其在210名65岁或以上晚期癌症患者中改善ACP过程的能力，并比较视频和口头叙述组之间患者对主要护理目标的选择所反映的临终偏好；, 3。目的：研究视频辅助决策在50名肿瘤医师临床实践中的应用情况。通过课程学习、研讨会以及拟议研究的发展和完成，Volandes博士计划提高他的方法技能和对卫生服务研究的理解；发展临终决策和ACP方面的专业知识；并收集有关使用视频决策辅助工具的数据，以促进向老年人提供高质量、偏好敏感的临终关怀。在未来，Volandes博士计划利用他获得的技能探索视频决策辅助对患有其他疾病的老年人的使用。获得K08职业发展奖将为Volandes博士提供最佳途径，以获得更多的研究技能和为老年癌症患者决策的专业知识。这个奖项也将进一步推动他的长期职业目标，成为一个熟练的和建立独立调查员在临终决定和沟通领域。

项目成果

Building on Individual, State, and Federal Initiatives for Advance Care Planning, an Integral Component of Palliative and End-of-Life Cancer Care.

以个人、州和联邦的预先护理计划倡议为基础，这是姑息治疗和临终癌症护理的一个组成部分。

• DOI: 10.1200/jop.2011.000355
• 发表时间: 2011
• 期刊: Journal of oncology practice
• 作者: Epstein,AndrewS;Volandes,AngeloE;O'Reilly,EileenM
• 通讯作者: O'Reilly,EileenM

Audio-video decision support for patients: the documentary genré as a basis for decision aids.

为患者提供音频-视频决策支持：作为决策辅助基础的纪录片类型。

• DOI: 10.1111/j.1369-7625.2011.00727.x
• 发表时间: 2013
• 期刊: Health expectations : an international journal of public participation in health care and health policy
• 作者: Volandes,AngeloE;Barry,MichaelJ;Wood,Fiona;Elwyn,Glyn
• 通讯作者: Elwyn,Glyn