|
1000
|
Abstract/Summary
|
-
<jats:title>Abstract</jats:title><jats:sec>
<jats:title>Background</jats:title>
<jats:p>Advance Care Planning interventions should be evaluated as broadly as possible to gain a holistic understanding of the Advance Care Planning process. However, validated early stage outcome instruments are lacking. Therefore, the Treatment-Preference-Measure-Advance Care Planning (Treat-Me-ACP) instrument was developed and validated as part of the cluster-randomized controlled trial STADPLAN (Study on Advance Care Planning in care-dependent community-dwelling older persons) to assess the effects of Advance Care Planning interventions on patients’ medical treatment preferences.</jats:p>
</jats:sec><jats:sec>
<jats:title>Methods</jats:title>
<jats:p>The design of Treat-Me-ACP is based on the Emanuel Medical Directive and the Life Support Preferences Questionnaires. Using a multi-stage team approach a preliminary version of the Treat-Me-ACP was developed and pre-tested. The pre-tested instrument consists of one <jats:italic>global medical care goal</jats:italic>-item, five hypothetical scenarios with five hypothetical treatments, and one <jats:italic>how would you feel-item</jats:italic> within each scenario. A total of five scenario preference scores and five treatment preference scores can be formed. This version was subsequently applied to a subsample of the STADPLAN project (<jats:italic>n</jats:italic> = 80) to assess patient’s preferences at baseline (T0) and at 12-month follow-up (T2). The further validation steps were based on this subsample and included: (1) acceptance by using completion rate and frequencies of missing data, (2) internal consistency by using Cronbach’s α to test whether it was possible to create preference scores by scenario and treatment, (3) concurrent validation examining the association between the <jats:italic>global medical care goal</jats:italic>-item and the preference scores and the association between the <jats:italic>how would you feel</jats:italic>-items and the scenario preference scores, and (4) responsiveness of the instrument to changes in preferences for life-sustaining treatments by comparing preference scores from T0 to T2 between study groups.</jats:p>
</jats:sec><jats:sec>
<jats:title>Results</jats:title>
<jats:p>Acceptance of the instrument was high. Results of concurrent validation indicate that the five scenarios represent the <jats:italic>global medical care goal</jats:italic> well. The preference scores showed an average tendency for decreasing preferences for life-sustaining treatments across all scales for the intervention group during study follow-up.</jats:p>
</jats:sec><jats:sec>
<jats:title>Conclusions</jats:title>
<jats:p>The Treat-Me-ACP can be used to evaluate the dynamics of patients’ medical treatment preferences in Advance Care Planning. It has been validated for care-dependent community-dwelling older persons and can be used as an additional outcome measure in evaluating the effectiveness of ACP interventions.</jats:p>
</jats:sec><jats:sec>
<jats:title>Trial registration</jats:title>
<jats:p>German Clinical Trials Register: DRKS00016886 on 04/06/2019.</jats:p>
</jats:sec>
|
|
1000
|
Hinweis
|
-
DeepGreen-ID: 994ea4014fb74dfaac10f893cdc709a8 ; metadata provieded by: DeepGreen (https://www.oa-deepgreen.de/api/v1/), LIVIVO search scope life sciences (http://z3950.zbmed.de:6210/livivo), Crossref Unified Resource API (https://api.crossref.org/swagger-ui/index.html), to.science.api (https://frl.publisso.de/), ZDB JSON-API (beta) (https://zeitschriftendatenbank.de/api/), lobid - Dateninfrastruktur für Bibliotheken (https://lobid.org/resources/search)
|
