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Barnett MD, Bennett-Leleux LJ, Guillory LA. End-of-life treatment preferences and advanced care planning among older adults. DEATH STUDIES 2024; 48:95-102. [PMID: 36931063 DOI: 10.1080/07481187.2023.2189326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
End-of-life treatment preferences (EOLTPs) refer to the amount of medical intervention an individual would wish to receive in a life-threatening scenario. This study aimed to investigate relationships between older adults' EOLTPs and advance care planning (ACP). Using archival data from two interview surveys of community-dwelling older adults (study 1 n = 331, study 2 n = 338; age 60-102), results found that a desire for less end-of-life medical intervention was associated with greater EOL discussion with physicians. This relationship was explained by greater death preparation and younger age. Older adults may use ACP to limit unwanted medical interventions.
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Affiliation(s)
- Michael D Barnett
- Department of Psychology and Counseling, The University of Texas at Tyler, Tyler, Texas, USA
| | - Lauren J Bennett-Leleux
- Deparment of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas, USA
| | - Logan A Guillory
- Department of Psychology and Counseling, The University of Texas at Tyler, Tyler, Texas, USA
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Dupont C, Smets T, Monnet F, Pivodic L, De Vleminck A, Van Audenhove C, Van den Block L. Defining the content of a website on advance care planning in dementia: a focus group study with family and health professionals. BMC Med Inform Decis Mak 2023; 23:254. [PMID: 37940991 PMCID: PMC10633945 DOI: 10.1186/s12911-023-02359-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/30/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Advance care planning (ACP) is a process that enables individuals to define goals and preferences for their future care. It is particularly relevant for people with dementia and their family. Interactive tools, such as websites, that encourage reflection, communication and/or documentation, may support this group in the ACP process. However, considering the specific needs of people with dementia, it is important to develop adapted tools for this population. This study was conducted to define the content of an interactive website for people with dementia and their family caregivers to support them in ACP and to assess the barriers and facilitators for potential users in finding and using such a website from the perspective of family caregivers and healthcare professionals. METHODS Online focus groups with family caregivers (serving both as potential users and proxies for people with dementia) and healthcare professionals caring for people with dementia, using a semi-structured topic guide. To analyse the data, we used thematic framework analysis with a combination of deductive and inductive approaches to coding. RESULTS We conducted 4 focus groups with family caregivers of people with dementia (n = 18) and 3 with healthcare professionals (n = 17). Regarding the content of the website, participants highlighted that information on ACP (what and why) and guidance on how to start talking about ACP throughout the dementia trajectory should be included on the website. To increase the usability of the website, most participants considered a text-to-speech and a print option as important functionalities. A lack of computer literacy was found to be the most significant barrier to finding and using the website. CONCLUSION A website for people with dementia and their family caregivers to support them in ACP should focus on comprehensive content on ACP, peer testimonials, and interactive communication tools. Moreover, there should be certain flexibility in navigating through the website so people with dementia and their family caregivers can use it at their own pace. As the next step, we will include people with dementia in developing the website.
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Affiliation(s)
- Charlèss Dupont
- VUB-UGhent End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB), Brussels, 1090, Belgium.
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussels, 1090, Belgium.
| | - Tinne Smets
- VUB-UGhent End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB), Brussels, 1090, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussels, 1090, Belgium
| | - Fanny Monnet
- VUB-UGhent End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB), Brussels, 1090, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussels, 1090, Belgium
| | - Lara Pivodic
- VUB-UGhent End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB), Brussels, 1090, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussels, 1090, Belgium
| | - Aline De Vleminck
- VUB-UGhent End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB), Brussels, 1090, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussels, 1090, Belgium
| | | | - Lieve Van den Block
- VUB-UGhent End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB), Brussels, 1090, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussels, 1090, Belgium
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Dupont C, Monnet F, Pivodic L, Vleminck AD, Audenhove CV, Van den Block L, Smets T. Evaluating an advance care planning website for people with dementia and their caregivers: Protocol for a mixed method study. Digit Health 2023; 9:20552076231197021. [PMID: 37654712 PMCID: PMC10467240 DOI: 10.1177/20552076231197021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2023] [Indexed: 09/02/2023] Open
Abstract
Background Web-based tools (e.g., websites, apps) for people with dementia and their family caregivers may be useful in supporting advance care planning (ACP). Using a user-centred design approach, we developed an ACP website for people with dementia and their families. This protocol describes how we will test and evaluate the ACP website. Publishing a study protocol can guide others who want to evaluate web-based tools. Moreover, the data collection methods used in this study are very innovative since they aim to involve people living with dementia without overburdening them. Methods We will conduct an evaluation study of the ACP website in Flanders, Belgium, using a convergent parallel mixed methods pre-post-test design with continuous follow-up. Thirty eligible dyads of people with mild to moderate dementia (both early and late onset) and their family caregivers will use the website in their everyday life for 8 weeks. We will evaluate the usage, usability, acceptability, and feasibility of the website, as well as the experiences of users. Additionally, we evaluate the effects of using the website on ACP readiness, ACP knowledge, attitudes, perceived barriers to engage in ACP, self-efficacy and skills to engage in ACP. Results Recruitment and data collection is foreseen between end of 2022 and 2023. Conclusion This evaluation study of an ACP website for people with dementia and their family caregivers will be the first to evaluate how a web-based tool can support people living with dementia and their families in ACP. The strength of this study lies in the combination of interviews, surveys, and ongoing data logging, which provide insights into the use of support tools in people's daily context. We expect that recruiting people with dementia and their families will be difficult so we have set up a thorough strategy to reach the anticipated sample size.
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Affiliation(s)
- Charlèss Dupont
- VUB-UGhent End-of-life Care Research Group, Vrije Universiteit Brussel, Brussel, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussel, Belgium
| | - Fanny Monnet
- VUB-UGhent End-of-life Care Research Group, Vrije Universiteit Brussel, Brussel, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussel, Belgium
| | - Lara Pivodic
- VUB-UGhent End-of-life Care Research Group, Vrije Universiteit Brussel, Brussel, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussel, Belgium
| | - Aline De Vleminck
- VUB-UGhent End-of-life Care Research Group, Vrije Universiteit Brussel, Brussel, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussel, Belgium
| | | | - Lieve Van den Block
- VUB-UGhent End-of-life Care Research Group, Vrije Universiteit Brussel, Brussel, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussel, Belgium
| | - Tinne Smets
- VUB-UGhent End-of-life Care Research Group, Vrije Universiteit Brussel, Brussel, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussel, Belgium
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Pivodic L, Wendrich-van Dael A, Gilissen J, De Buyser S, Deliens L, Gastmans C, Vander Stichele R, Van den Block L. Effects of a theory-based advance care planning intervention for nursing homes: A cluster randomized controlled trial. Palliat Med 2022; 36:1059-1071. [PMID: 35769038 DOI: 10.1177/02692163221102000] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Uptake of advance care planning in routine nursing home care is low. Through extensive literature review, theoretical development, and stakeholder involvement, we developed the ACP+ intervention. AIMS To evaluate the effects of ACP+ on the knowledge and self-efficacy (confidence in own skills) of nursing home care staff concerning advance care planning. DESIGN Cluster randomized controlled trial, conducted between February 2018 and January 2019 (NCT03521206, clinicaltrials.gov). ACP+ is a multicomponent intervention aimed at training and supporting nursing home staff and management in implementing advance care planning in nursing home practice through a train-the-trainer approach over 8 months. Fourteen nursing homes were randomized using a matched-pairing strategy, seven received ACP+, seven followed usual practice. Analyses (intention-to-treat) involved linear mixed models. SETTING/PARTICIPANTS Nursing homes in Flanders (Belgium). RESULTS 694 of 1017 care staff (68% response rate) at baseline and 491 of 989 care staff (50%) post-intervention (8 months) returned questionnaires. Post-intervention, care staff's self-efficacy concerning advance care planning was significantly higher in the intervention than in the control group (baseline-adjusted mean difference 0.57; 95% CI 0.20-0.94; p = 0.003; Cohen's d = 0.30). Advance care planning knowledge (95% CI 0.95-1.15; p = 0.339; ratio: 1.04) did not differ significantly between groups. CONCLUSIONS The ACP+ intervention for nursing homes improved care staff's self-efficacy but not their knowledge concerning advance care planning. Considering the comprehensive and multi-component approach used, these effects were smaller than expected. Reasons for this may be related to the chosen follow-up period, outcomes and measurements, or to the intervention itself and its implementation.
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Affiliation(s)
- Lara Pivodic
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Brussels, Belgium.,Vrije Universiteit Brussel (VUB), Department of Family Medicine and Chronic Care, Brussels, Belgium
| | - Annelien Wendrich-van Dael
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Brussels, Belgium.,Vrije Universiteit Brussel (VUB), Department of Family Medicine and Chronic Care, Brussels, Belgium
| | - Joni Gilissen
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Brussels, Belgium.,Atlantic Fellows for Equity in Brain Health, Global Brain Health Institute, University California San Francisco, San Francisco, CA, USA
| | - Stefanie De Buyser
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Luc Deliens
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Brussels, Belgium.,Vrije Universiteit Brussel (VUB), Department of Family Medicine and Chronic Care, Brussels, Belgium.,Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Chris Gastmans
- Centre for Biomedical Ethics and Law, KU Leuven, Leuven, Belgium
| | | | - Lieve Van den Block
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Brussels, Belgium.,Vrije Universiteit Brussel (VUB), Department of Family Medicine and Chronic Care, Brussels, Belgium
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Garden G, Usman A, Readman D, Storey L, Wilkinson L, Wilson G, Dening T, Gordon AL, Gladman JRF. Advance care plans in UK care home residents: a service evaluation using a stepped wedge design. Age Ageing 2022; 51:6555262. [PMID: 35348604 PMCID: PMC8963445 DOI: 10.1093/ageing/afac069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Indexed: 11/14/2022] Open
Abstract
Introduction advance care planning (ACP) in care homes has high acceptance, increases the proportion of residents dying in place and reduces hospital admissions in research. We investigated whether ACP had similar outcomes when introduced during real-world service implementation. Methods a service undertaking ACP in Lincoln, UK care homes was evaluated using routine data. Outcomes were proportion of care homes and residents participating in ACP; characteristics of residents choosing/declining ACP and place of death for those with/without ACP. Hospital admissions were analysed using mixed-effects Poisson regression for number of admissions, and a mixed-effects negative binomial model for number of occupied hospital bed days. Results About 15/24 (63%) eligible homes supported the service, in which 404/508 (79.5%) participants chose ACP. Residents choosing ACP were older, frailer, more cognitively impaired and malnourished; 384/404 (95%) residents choosing ACP recorded their care home as their preferred place of death: 380/404 (94%) declined cardiopulmonary resuscitation. Among deceased residents, 219/248 (88%) and 33/49 (67%) with and without advance care plan respectively died in their care home (relative risk 1.35, 95% confidence interval [CI] 1.1–1.6, P < 0.001). Hospital admission rates and bed occupancy did not differ after implementation. Discussion About 79.5% participants chose ACP. Those doing so were more likely to die at home. Many homes were unwilling or unable to support the service. Hospital admissions were not reduced. Further research should consider how to enlist the support of all homes and to explore why hospital admissions were not reduced.
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Affiliation(s)
- Gill Garden
- Lincoln Medical School, University of Lincoln, Lincoln, UK.,United Lincolnshire Hospitals Trust, Lincoln, UK
| | - Adeela Usman
- School of Medicine, University of Nottingham, Nottingham, UK
| | | | | | | | - Graham Wilson
- Lincolnshire Community Health Services Trust, Lincoln, UK
| | - Tom Dening
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Adam L Gordon
- School of Medicine, University of Nottingham, Nottingham, UK.,NIHR Applied Research Centre-East Midlands (ARC-EM), Nottingham, UK.,NIHR Nottingham Biomedical Research Centre, Nottingham, UK.,University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - John R F Gladman
- School of Medicine, University of Nottingham, Nottingham, UK.,NIHR Applied Research Centre-East Midlands (ARC-EM), Nottingham, UK.,NIHR Nottingham Biomedical Research Centre, Nottingham, UK.,Nottingham University Hospitals NHS Trust, Nottingham, UK
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Stevens J, Pype P, Eecloo K, Deliens L, Pardon K, De Vleminck A. Facilitating advance care planning in the general practice setting for patients with a chronic, life-limiting illness: protocol for a phase-III cluster-randomized controlled trial and process evaluation of the ACP-GP intervention. BMC Palliat Care 2021; 20:97. [PMID: 34172030 PMCID: PMC8231078 DOI: 10.1186/s12904-021-00796-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 06/08/2021] [Indexed: 11/10/2022] Open
Abstract
Background Advance care planning (ACP), a process of communication about patients’ preferences for future medical care, should be initiated in a timely manner. Ideally situated for this initiation is the general practitioner (GP). The intervention to improve the initiation of ACP for patients with a chronic life-limiting illness in general practice (ACP-GP) includes an ACP workbook for patients, ACP communication training for GPs, planned ACP conversations, and documentation of ACP conversation outcomes in a structured template. We present the study protocol of a Phase-III randomized controlled trial (RCT) of ACP-GP that aims to evaluate its effects on outcomes at the GP, patient, and surrogate decision maker (SDM) levels; and to assess the implementation process of the intervention. Methods This RCT will take place in Flanders, Belgium. Thirty-six GPs, 108 patients with a chronic, life-limiting illness, and their (potential) SDM will be recruited, then cluster-randomized to the ACP-GP intervention or the control condition. The primary outcome for GPs is ACP self-efficacy; primary outcome for patients is level of ACP engagement. Secondary outcomes for GPs are ACP practices, knowledge and attitudes; and documentation of ACP discussion outcomes. Secondary outcomes for patients are quality of life; anxiety; depression; appointment of an SDM; completion of new ACP documents; thinking about ACP; and communication with the GP. The secondary outcome for the SDM is level of engagement with ACP. A process evaluation will assess the recruitment and implementation of the intervention using the RE-AIM framework. Discussion While the general practice setting holds promise for timely initiation of ACP, there is a lack of randomized trial studies evaluating the effectiveness of ACP interventions implemented in this setting. After this Phase-III RCT, we will be able to present valuable evidence of the effects of this ACP-GP intervention, with the potential for offering a well-tested and evaluated program to be implemented in general practice. The results of the process evaluation will provide insight into what contributes to or detracts from implementation success, as well as how the intervention can be adapted to specific contexts or needs. Trial registration Prospectively registered at with ISRCTN (ISRCTN12995230); registered 19/06/2020. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-021-00796-1.
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Affiliation(s)
- Julie Stevens
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Laarbeeklaan 103, 1090, Brussels, Belgium. .,Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium.
| | - Peter Pype
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Laarbeeklaan 103, 1090, Brussels, Belgium.,Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Kim Eecloo
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Laarbeeklaan 103, 1090, Brussels, Belgium.,Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Luc Deliens
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Laarbeeklaan 103, 1090, Brussels, Belgium.,Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Koen Pardon
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Laarbeeklaan 103, 1090, Brussels, Belgium.,Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
| | - Aline De Vleminck
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Laarbeeklaan 103, 1090, Brussels, Belgium.,Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
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Wendrich-van Dael A, Gilissen J, Van Humbeeck L, Deliens L, Vander Stichele R, Gastmans C, Pivodic L, Van den Block L. Advance care planning in nursing homes: new conversation and documentation tools. BMJ Support Palliat Care 2021; 11:312-317. [PMID: 34162581 PMCID: PMC8380900 DOI: 10.1136/bmjspcare-2021-003008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/02/2021] [Indexed: 02/07/2023]
Abstract
Although advance care planning (ACP) is highly relevant for nursing home residents, its uptake in nursing homes is low. To meet the need for context-specific ACP tools to support nursing home staff in conducting ACP conversations, we developed the ACP+intervention. At its core, we designed three ACP tools to aid care staff in discussing and documenting nursing home resident's wishes and preferences for future treatment and care: (1) an extensive ACP conversation guide, (2) a one-page conversation tool and (3) an ACP document to record outcomes of conversations. These nursing home-specific ACP tools aim to avoid a purely document-driven or 'tick-box' approach to the ACP process and to involve residents, including those living with dementia according to their capacity, their families and healthcare professionals.
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Affiliation(s)
- Annelien Wendrich-van Dael
- End-of-Life Care Research Group, Vrije Universiteit Brussel, Brussels, Belgium .,Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
| | - Joni Gilissen
- End-of-Life Care Research Group, Vrije Universiteit Brussel, Brussels, Belgium.,Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium.,Neurology, UCSF, San Francisco, California, USA
| | - Liesbeth Van Humbeeck
- Department of Geriatric Medicine, University Hospital Ghent, Gent, Oost-Vlaanderen, Belgium
| | - Luc Deliens
- End-of-Life Care Research Group, Vrije Universiteit Brussel, Brussels, Belgium.,Medical Oncology, Ghent University Hospital, Ghent, Belgium
| | | | - Chris Gastmans
- Interfacultair Centrum voor Biomedische Ethiek en Recht, KULeuven, Leuven, Belgium
| | - Lara Pivodic
- End-of-Life Care Research Group, Vrije Universiteit Brussel, Brussels, Belgium.,Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
| | - Lieve Van den Block
- End-of-Life Care Research Group, Vrije Universiteit Brussel, Brussels, Belgium.,Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
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Lasmarías C, Subirana-Casacuberta M, Mancho N, Aradilla-Herrero A. Spanish Cross-Cultural Adaptation and Psychometric Properties of the Advance Care Planning Self-Efficacy: A Cross-Sectional Study. J Palliat Med 2021; 24:1807-1815. [PMID: 34143670 DOI: 10.1089/jpm.2020.0653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Perceived self-efficacy in advance care planning (ACP) is frequently used to measure the impact of ACP programs for professionals responsible for advanced chronic patients. A validated ACP Self-Efficacy (ACP-SE) scale is not currently available in Spanish. Objective: To culturally adapt and validate Baughman's ACP-SE scale into Spanish (ACP-SEs). Methodology/Design: An instrumental study was performed in two phases: (1) cultural adaptation of the ACP-SE scale and (2) psychometric properties measurement. Setting/Participants: The survey was sent to 5785 professionals: physicians, nurses, psychologists, and social workers, members of scientific associations in the areas of primary care, geriatrics, and palliative care in Catalonia, Spain. Results: Five hundred thirty-eight questionnaires were obtained, respondents were physicians (69.0%) and nurses (28.4%) and mean age was 47 years (standard deviation [SD] = 10.1). Most were women (79.6%), 68% had >15 years of professional experience, and 80.7% worked in primary care. Internal consistency was high (Cronbach's alpha = 0.95) and showed a unidimensional structure explaining 56.2% of total variance. Mean score was 67.37 (SD = 16.1). Variables associated with greater self-efficacy were previous training (t = -3.23, df = 273.76, p = 0.001), previous participation in ACP processes (t = -6.23, df = 521, p < 0.001), and membership in geriatric or palliative care scientific association (p < 0.001). ACP-SEs positively correlated to other compared scales. Conclusion: The ACP-SE scale demonstrates adequate psychometric properties. This is the first self-efficacy scale for ACP in Spanish. It should facilitate a better understanding of implementation processes related to ACP programs for professionals involved in caring for patients with advanced diseases.
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Affiliation(s)
- Cristina Lasmarías
- Department of Education and Training, Catalan Institute of Oncology, Barcelona, Spain.,Catalonia Chronic Care Research Group, University of Vic-Central University of Catalonia, Vic, Barcelona, Spain
| | - Mireia Subirana-Casacuberta
- Nursing Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain; Consorci Sanitari Parc Taulí, Sabadell, Spain.,Research Group on Methodology, Methods, Models, and Health and Social Outcomes, Faculty of Health Science and Welfare, Centre for Health and Social Care Research, University of Vic-Central University of Catalonia, Vic, Barcelona, Spain
| | - Núria Mancho
- Department of Statistics, Biomedical Research Institute of Bellvitge (IDIBELL), Barcelona, Spain
| | - Amor Aradilla-Herrero
- Escoles Universitàries Gimbernat (Universitat Autònoma de Barcelona), Sant Cugat del Vallès, Barcelona, Spain
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Advocacy for the human rights of older people in the COVID pandemic and beyond: a call to mental health professionals. Int Psychogeriatr 2020; 32:1199-1204. [PMID: 32487280 PMCID: PMC7302948 DOI: 10.1017/s1041610220001076] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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