Experiences with and Outcomes of Advance Care Planning in Bereaved Relatives of Frail Older Patients: A Mixed Methods Study
| العنوان: | Experiences with and Outcomes of Advance Care Planning in Bereaved Relatives of Frail Older Patients: A Mixed Methods Study |
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| المؤلفون: | Ida J. Korfage, Judith A.C. Rietjens, Bernard J. Hammes, Agnes van der Heide, Anouk Overbeek |
| المساهمون: | Public Health |
| المصدر: | Age and Ageing, 48(2), 299-306. Oxford University Press |
| بيانات النشر: | Oxford University Press, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Male, Advance care planning, Aging, medicine.medical_specialty, Randomization, Frail Elderly, Decision Making, Anxiety, Affect (psychology), law.invention, Advance Care Planning, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Humans, Medicine, Family, 030212 general & internal medicine, Cluster randomised controlled trial, Depression (differential diagnoses), Aged, 80 and over, Depression, business.industry, General Medicine, Middle Aged, Family medicine, Preparedness, Female, Geriatrics and Gerontology, medicine.symptom, business, 030217 neurology & neurosurgery, Bereavement |
| الوصف: | Background Advance Care Planning (ACP) may prepare relatives of frail older patients for future decision-making. Objective to investigate (1) how bereaved relatives of frail older patients experience ACP conversations and (2) whether ACP has an effect on relatives' preparation for decision-making and on their levels of anxiety and depression. Design cluster randomised controlled trial. Setting residential care homes in the Netherlands and community setting. Subjects bereaved relatives of care home residents and community-dwelling frail older patients. Methods we randomised 16 residential care homes to either the intervention group, where patient-participants were offered facilitated ACP, or the control group (n = 201), where they received 'care as usual'. If patient-participants died, we approached relatives for an interview. We asked relatives who had attended ACP conversations for their experience with ACP (open-ended questions). Furthermore, we compared relatives' preparation levels for decision-making and levels of anxiety and depression (HADS) between groups. This trial was registered (NTR4454). Results we conducted interviews with 39/51 (76%) bereaved relatives (intervention group: n = 20, control group: n = 19). Relatives appreciated the ACP conversations. A few considered ACP redundant since they were already aware of the patients' preferences. Nine of 10 relatives in the intervention group felt adequately prepared for decision-making as compared to 5 of 11 relatives in the control group (P = 0.03). Relatives' levels of anxiety and depression did not differ significantly between groups. Conclusions in our study, bereaved relatives of frail older patients appreciated ACP. ACP positively affected preparedness for decision-making. It did not significantly affect levels of anxiety or depression. |
| تدمد: | 1468-2834 0002-0729 |
| DOI: | 10.1093/ageing/afy184 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0479a0f18e55f129729287dd5d86645f https://doi.org/10.1093/ageing/afy184 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....0479a0f18e55f129729287dd5d86645f |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14682834 00020729 |
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| DOI: | 10.1093/ageing/afy184 |