A Community-based Advance Care Planning Programme for Patients With Advanced Disease
|ClinicalTrials.gov Identifier: NCT02068651|
Recruitment Status : Completed
First Posted : February 21, 2014
Last Update Posted : August 19, 2016
|Condition or disease||Intervention/treatment||Phase|
|Chronic Disease||Behavioral: Advance care planning programme||Not Applicable|
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||239 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||Triple (Participant, Care Provider, Outcomes Assessor)|
|Primary Purpose:||Health Services Research|
|Official Title:||A Community-based Advance Care Planning Programme to Improve End-of-life Care in Patients With Advanced Disease: A Mixed-method Approach|
|Study Start Date :||March 2014|
|Actual Primary Completion Date :||March 2016|
|Actual Study Completion Date :||March 2016|
Experimental: Advance care planning programme
Participants in the experimental group will receive a structured advance care planning programme, namely Let Me Talk, delivered by a trained nurse facilitator. The programme will be conducted on individual basis through three one-hour home visits, once weekly. Family carers of the participants will be invited to all sessions.
Behavioral: Advance care planning programme
It is a multi-faceted programme which includes an educational component with support of multimedia materials, reflection on personal values and a facilitated discussion between patient and family carer over future care. It will be delivered to each pair of participant and family carer on individual basis. By the end of the programme, each participant will have a personal workbook summarising the advance care planning process for record.
No Intervention: Usual care
Participants in the control group will receive three weekly home visits with basic health assessment and education provided by the trained nurse facilitator. If they request advance care planning information or assistance, an advance directive form, which is available on the Internet for public access, will be provided to them for their information.
- End-of-life care preferences [ Time Frame: 6 months ]In this study, end-of-life care preferences include goal for end-of-life care and decisions over the use of life-sustaining treatments relevant to individual's anticipated health changes. So, whether the patients' end-of-life care preferences is known at different timepoints will be determined based on (1) the congruence between patients' end-of-life care preferences and family carers' predicted end-of-life care preferences for patients; and (2) whether patients' end-of-life preferences are documented in their medical record.
- Level of certainty about future care [ Time Frame: 6 months ]The SURE test (Legare, Kearing, Clay, Gagnon, D'Amours, Rousseau & O'Connor, 2010) will be used to measure the patient's level of decisional conflict in making decisions related to future care. Patients will be asked to rate their certainty in their future care on four items by using a dichotomous response format: yes or no. Good construct validity and reliability were demonstrated. It has previously been translated into Chinese and tested among local older people .
- Health care utilization [ Time Frame: 6 months ]Patient's medical records will be retrieved retrospectively six months after their enrolment to review their health care utilization over the study period, including the number of visits to the emergency department, unplanned admission, length of hospital stay, as well as investigation, procedures and treatment received.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02068651
|Haven of Hope Hospital|
|Hong Kong, Hong Kong|
|Principal Investigator:||Helen Chan, RN PhD||The Nethersole School of Nursing, The Chinese University of Hong Kong|
|Principal Investigator:||Diana Lee, RN PhD||The Nethersole School of Nursing, The Chinese University of Hong Kong|
|Principal Investigator:||Carmen Chan, RN PhD||The Nethersole School of Nursing, The Chinese University of Hong Kong|
|Principal Investigator:||Iris Lee, RN PhD||The Nethersole School of Nursing, The Chinese University of Hong Kong|
|Principal Investigator:||Doris Leung, PhD||The Nethersole School of Nursing, The Chinese University of Hong Kong|