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Patient Educ Couns. 2004 Oct;55(1):22-31.

Using a Values Discussion Guide to facilitate communication in advance care planning.

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1
VA Boston Healthcare System and Department of Psychiatry, Harvard Medical School, VA Medical Center 3-5-C, 940 Belmont Street, Brockton, MA 02301, USA. michele.karel@med.va.gov

Abstract

The utility of values clarification tools for advance care planning needs further study. This descriptive, qualitative study aimed to describe patients' and surrogates' experiences using a Values Discussion Guide (VDG), both with and without a professional facilitator. Ten male Veterans Health Administration outpatients over age 50 and their health care agents completed audio-taped discussions, both without and with a facilitator, and responded to structured feedback interviews. Most participants found a discussion using the VDG to be helpful and reassuring. Discussions varied in quantity and quality, and participants varied in preferring self-guided versus professionally facilitated discussions. The best interchanges were elicited by questions about prior experience with medical decisions, for oneself or others, and trusted versus non-trusted others to help with decision-making. A VDG appears a useful tool in a repertoire of advance care planning tools, which need to be geared towards the needs and abilities of particular patients and families.

PMID:
15476986
DOI:
10.1016/S0738-3991(03)00246-5
[Indexed for MEDLINE]
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